Syed Shahabuddin X, RPH
Individual provider Active NPI Pharmacist · Pok, NY
NPI 1063597680 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1063597680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 031042 (NY)
- Practice address
- 1895 South Rd
Pok, NY 12601 - Phone
- (845) 298-0097
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoprite Supermarkets, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 031042 | NY | Yes |
Addresses
Primary practice location
1895 South Rd
Pok, NY 12601
Mailing address
19 Bell Air LN
Wappingers Falls, NY 12590-4414
Phone (845) 297-1394
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.