Provider Demographics
NPI:1548911134
Name:KHALEEL, IQRA (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:IQRA
Middle Name:
Last Name:KHALEEL
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 ONDERDONK AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-1336
Mailing Address - Country:US
Mailing Address - Phone:718-381-3622
Mailing Address - Fax:
Practice Address - Street 1:389 ONDERDONK AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1336
Practice Address - Country:US
Practice Address - Phone:718-381-3622
Practice Address - Fax:718-381-7992
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27906183500000X
NY069122183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist