Provider Demographics
NPI:1811214224
Name:BAKAR, SHAMSUL KARIM (RPH)
Entity Type:Individual
Prefix:MR
First Name:SHAMSUL
Middle Name:KARIM
Last Name:BAKAR
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 1:545 SAINT PAULS PL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-2122
Mailing Address - Country:US
Mailing Address - Phone:718-992-6881
Mailing Address - Fax:718-992-0055
Practice Address - Street 1:545 SAINT PAULS PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-2122
Practice Address - Country:US
Practice Address - Phone:718-992-6881
Practice Address - Fax:718-992-0055
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-24
Last Update Date:2010-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist