Provider Demographics
NPI:1396873469
Name:MUZAFFAR, SYED A
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:A
Last Name:MUZAFFAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1515
Mailing Address - Country:US
Mailing Address - Phone:516-747-7214
Mailing Address - Fax:
Practice Address - Street 1:993 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-2903
Practice Address - Country:US
Practice Address - Phone:718-328-3593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist