Provider Demographics
NPI:1851452098
Name:NADEEM, ABID (RPH)
Entity Type:Individual
Prefix:
First Name:ABID
Middle Name:
Last Name:NADEEM
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 1:1265 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-7203
Mailing Address - Country:US
Mailing Address - Phone:212-781-4214
Mailing Address - Fax:212-781-4758
Practice Address - Street 1:1265 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-7203
Practice Address - Country:US
Practice Address - Phone:212-781-4214
Practice Address - Fax:212-781-4758
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4225170001OtherUNSPECIFIED
NY4225170001Medicare NSC