Provider Demographics
NPI:1912445008
Name:MOHAMED, MOHAMED SAID (RPH)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:SAID
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 MAIN ST APT G
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-1439
Mailing Address - Country:US
Mailing Address - Phone:973-668-6586
Mailing Address - Fax:
Practice Address - Street 1:2262 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:347-879-8144
Practice Address - Fax:347-879-8146
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist