Provider Demographics
NPI:1245719855
Name:SARWAR, ISHMAM (PHARMD)
Entity type:Individual
Prefix:
First Name:ISHMAM
Middle Name:
Last Name:SARWAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12117 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2524
Mailing Address - Country:US
Mailing Address - Phone:718-849-9800
Mailing Address - Fax:
Practice Address - Street 1:6920 43RD AVE APT 3
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3986
Practice Address - Country:US
Practice Address - Phone:347-832-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist