Individual provider Active NPI

Mohammed Islam

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1831860709
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
068186 Issued in NY
Practice address
411 Ditmas Ave
Brooklyn, NY 11218-4919
Phone
(718) 435-7101
NPI assigned
Sep 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 068186 NY Primary

Addresses

Primary practice location

411 Ditmas Ave
Brooklyn, NY 11218-4919

Mailing address

258 Dahill Rd
Brooklyn, NY 11218-3802
Phone (347) 469-5677

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

State licenses

LicenseStateTypeSpecialty
068186NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC PastSince Sep 28, 2021 Accepting new patients
CVS Albany LLC PastSince Sep 28, 2021 Accepting new patients

Organizations & group practices 2

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": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1831860709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 DAHILL RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183802",
            "telephone_number": "347-469-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 DITMAS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184919",
            "telephone_number": "718-435-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISLAM",
        "first_name": "MOHAMMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "068186",
            "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 Sep 21, 2021; 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.