Provider Demographics
NPI:1184392144
Name:UZAGIR, KHAMATTIE (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:KHAMATTIE
Middle Name:
Last Name:UZAGIR
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8710 149TH AVE APT 5F
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1432
Mailing Address - Country:US
Mailing Address - Phone:347-698-7743
Mailing Address - Fax:
Practice Address - Street 1:194 BEACH 116TH ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-2417
Practice Address - Country:US
Practice Address - Phone:718-318-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068126183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist