Ridwan Islam

Primary specialty

PharmacistTaxonomy code 183500000X

License

064982 Issued in NY

Practice address

21444 Hillside Ave
Queens Village, NY 11427-1830

Phone

(718) 776-1123

NPI assigned

Feb 14, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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.

• Queens Village Pharmacy Inc.

  • Pharmacy
  • Queens Village, NY
  • NPI 1164943981
  NPD (past)

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1669938643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21815 94TH DR",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114282101",
            "telephone_number": "347-882-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21444 HILLSIDE AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271830",
            "telephone_number": "718-776-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "RIDWAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Julian Isaacs, D.D.S.
• Emilia Leah Isaacs, LP-MHC
• Bolaji Isijola
• Ella Iskhakov, FNP
• Mohammad Islam
• Hollis Beth Israel
• Marie Israel
• Justin Itteera, M.D.
• Jackie R. Chessen Consulting
• Melissa Jacob, NP

• Pharmacist in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.