Provider Demographics
NPI:1790519205
Name:MAHMUD, MOHAMMAD ZAKWAN (PHARMD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD ZAKWAN
Middle Name:
Last Name:MAHMUD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 E HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4526
Mailing Address - Country:US
Mailing Address - Phone:585-321-2581
Mailing Address - Fax:
Practice Address - Street 1:2580 E HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4526
Practice Address - Country:US
Practice Address - Phone:585-321-2581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist