Provider Demographics
NPI:1144553090
Name:MUYIR, HASSAN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:HASSAN
Middle Name:
Last Name:MUYIR
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-1034
Mailing Address - Country:US
Mailing Address - Phone:718-439-1570
Mailing Address - Fax:718-439-1567
Practice Address - Street 1:4620 3RD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-1034
Practice Address - Country:US
Practice Address - Phone:718-439-1570
Practice Address - Fax:718-439-1567
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049577183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03892660Medicaid