Provider Demographics
NPI:1720449903
Name:MOHAMMED, ROSEMARIE (RPH)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:
Last Name:MOHAMMED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11050 71ST RD
Mailing Address - Street 2:SUITE 7C
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4969
Mailing Address - Country:US
Mailing Address - Phone:718-544-5733
Mailing Address - Fax:
Practice Address - Street 1:11050 71ST RD
Practice Address - Street 2:SUITE 7C
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4969
Practice Address - Country:US
Practice Address - Phone:718-544-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041000183500000X, 1835G0303X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric