Mirit A Fahim, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

055204-1 Issued in NY

Practice address

1 Vermont Dr
New Hyde Park, NY 11042-1128

Phone

(877) 501-0108

NPI assigned

Sep 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912426792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VERMONT DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421128",
            "telephone_number": "877-501-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VERMONT DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421128",
            "telephone_number": "877-501-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHIM",
        "first_name": "MIRIT",
        "middle_name": "A",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NY",
            "license": "055204-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "055204-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "28RI03247400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Danielle C Ezzo, PHARM.D.
• Marilyn Fabbri, M.D.
• Fabiola Milord, DDS, MPH, PLLC
• David A Faitell, MD
• Igor R Faiz, PA-C
• Alefiya Faizullabhoy, MBA, MS,RD, CDE,CDN
• Joshua Falescky, MD
• Adam Faletsky

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.