Provider Demographics
NPI:1558684993
Name:SHEIKH, SAFDAR M (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:SAFDAR
Middle Name:M
Last Name:SHEIKH
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 E 138TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-3307
Mailing Address - Country:US
Mailing Address - Phone:718-665-9179
Mailing Address - Fax:718-665-9192
Practice Address - Street 1:679 E 138TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-3307
Practice Address - Country:US
Practice Address - Phone:718-665-9179
Practice Address - Fax:718-665-9192
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033155-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00944216Medicaid