Provider Demographics
NPI:1043004484
Name:MUSAH, FATIMA
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:MUSAH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 CRESTON AVE APT 4C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4266
Mailing Address - Country:US
Mailing Address - Phone:347-837-9912
Mailing Address - Fax:
Practice Address - Street 1:660 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-1603
Practice Address - Country:US
Practice Address - Phone:718-484-8553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist