Provider Demographics
NPI:1568242741
Name:HASHAM, MAHMOOD
Entity Type:Individual
Prefix:
First Name:MAHMOOD
Middle Name:
Last Name:HASHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 ROUTE 9 NORTH
Mailing Address - Street 2:
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726
Mailing Address - Country:US
Mailing Address - Phone:732-972-2333
Mailing Address - Fax:732-972-5349
Practice Address - Street 1:324 ROUTE 9 NORTH
Practice Address - Street 2:ADDRESS LINE 2
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726
Practice Address - Country:US
Practice Address - Phone:732-972-2333
Practice Address - Fax:732-972-5349
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02607900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty