Individual provider Active NPI

Ghulam Murtaza, R.PH.

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1518282425
Registry record updated Apr 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
031405 Issued in NY
Practice address
642 Sutter Ave
Brooklyn, NY 11207-4113
Phone
(718) 346-9512
Fax
(718) 346-7059
NPI assigned
Apr 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 031405 NY Primary

Addresses

Primary practice location

642 Sutter Ave
Brooklyn, NY 11207-4113

Mailing address

182 Lodge Ave
Huntington Station, NY 11746-2830
Phone (631) 988-0165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
031405NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grandbrook Pharmacy Inc Current Accepting new patients

Locations

642 Sutter Ave
Brooklyn, NY 11207
Phone (718) 346-9512

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1270166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270166400000",
    "number": "1518282425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 LODGE AVE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117462830",
            "telephone_number": "631-988-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 SUTTER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112074113",
            "telephone_number": "718-346-9512",
            "fax_number": "718-346-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURTAZA",
        "first_name": "GHULAM",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-02",
        "last_updated": "2010-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "031405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2010; 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.