Provider Demographics
NPI:1962685503
Name:JAMALUDDIN, SYED (RPH)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:
Last Name:JAMALUDDIN
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 1:3557 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-5702
Mailing Address - Country:US
Mailing Address - Phone:516-536-5550
Mailing Address - Fax:516-536-5824
Practice Address - Street 1:3557 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-5702
Practice Address - Country:US
Practice Address - Phone:516-536-5550
Practice Address - Fax:516-536-5824
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist