Provider Demographics
NPI:1689735243
Name:SHARIEF, SAMIULLA (RPH)
Entity Type:Individual
Prefix:MR
First Name:SAMIULLA
Middle Name:
Last Name:SHARIEF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 TULIP AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2800
Mailing Address - Country:US
Mailing Address - Phone:516-354-7468
Mailing Address - Fax:
Practice Address - Street 1:1711 PITKIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-6601
Practice Address - Country:US
Practice Address - Phone:718-346-7200
Practice Address - Fax:718-495-1321
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY032250OtherSTATE PHARMACIT LICENSE