Provider Demographics
NPI:1619142080
Name:HAMEED, ABDUL (BS)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:
Last Name:HAMEED
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:NONE
Other - Middle Name:NONE
Other - Last Name:NONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:3350 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-2034
Mailing Address - Country:US
Mailing Address - Phone:718-827-9034
Mailing Address - Fax:718-827-1414
Practice Address - Street 1:3350 FULTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-2034
Practice Address - Country:US
Practice Address - Phone:718-827-9034
Practice Address - Fax:718-827-1414
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02908785Medicaid