Mohammad Mainul Islam

Primary specialty

PharmacistTaxonomy code 183500000X

License

I055699 Issued in NY

Practice address

780 E Main St
Stamford, CT 06902-3832

Phone

(203) 353-9117

NPI assigned

Mar 19, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Stamford, CT
  • NPI 1346498235
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1437424892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26203 E WILLISTON AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110011146",
            "telephone_number": "718-536-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 E MAIN ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023832",
            "telephone_number": "203-353-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MOHAMMAD",
        "middle_name": "MAINUL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "0011125",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "I055699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iphresh Nutrition
• Iris Wertheim M.D. LLC
• Iron Health Stamford PLLC
• Irwin Potkewitz, M.D.,P.C.
• Julia Sarah Isaac
• Carolyn Ismach, M.A. CCC
• David J Israel, PSY.D.
• Shara Pulver Israel, M.D.
• Arlene Isseks, MS, RDN
• Srivalli Isukapalli, PA-C

• Pharmacist in Stamford, CT
• Providers in Stamford, CT by specialty
• Pharmacist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.