Provider Demographics
NPI:1679898787
Name:KASHMIRI, MOHTASHAM ALI (PHARM D)
Entity Type:Individual
Prefix:
First Name:MOHTASHAM
Middle Name:ALI
Last Name:KASHMIRI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3243 91ST ST
Mailing Address - Street 2:APT.604
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-2364
Mailing Address - Country:US
Mailing Address - Phone:718-918-4502
Mailing Address - Fax:
Practice Address - Street 1:3243 91ST ST
Practice Address - Street 2:APT.604
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369-2364
Practice Address - Country:US
Practice Address - Phone:718-918-4502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist