Individual provider Active NPI

Mohammed Obaidullah, PHARM. D

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1801119920
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20054382 Issued in NY
Practice address
1281 Fulton St
Brooklyn, NY 11216-2011
Phone
(718) 398-2074
Fax
(718) 398-3081
NPI assigned
Mar 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20054382 NY Primary

Addresses

Primary practice location

1281 Fulton St
Brooklyn, NY 11216-2011

Mailing address

1281 Fulton St
Brooklyn, NY 11216-2011
Phone (718) 398-2074

Other practice location 1

15934 Jamaica Ave
Jamaica, NY 11432-6001
Phone (718) 658-7998

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
20054382NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince May 1, 2022 Accepting new patients
Walgreen Co PastSince Dec 6, 2020 Accepting new patients
Walgreen Co Past Accepting new patients

Locations

1281 Fulton St
Brooklyn, NY 11216
Phone (718) 398-2074

Organizations & group practices 3

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": "1267574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1801119920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162011",
            "telephone_number": "718-398-2074",
            "fax_number": "718-398-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1281 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162011",
            "telephone_number": "718-398-2074",
            "fax_number": "718-398-3081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15934 Jamaica Ave",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114326001",
            "country_code": "US",
            "telephone_number": "718-658-7998",
            "fax_number": "718-658-2854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBAIDULLAH",
        "first_name": "MOHAMMED",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-03",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "20054382",
            "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 Dec 2, 2020; 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.