Provider Demographics
NPI:1972826022
Name:HAQUE, MOHAMMED NURUL (RPH)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:NURUL
Last Name:HAQUE
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 1:511 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-4515
Mailing Address - Country:US
Mailing Address - Phone:718-466-5500
Mailing Address - Fax:718-466-5505
Practice Address - Street 1:511 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4515
Practice Address - Country:US
Practice Address - Phone:718-466-5500
Practice Address - Fax:718-466-5505
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY38538183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist