Provider Demographics
NPI:1780754697
Name:ANAM, KAZI M (RPH)
Entity type:Individual
Prefix:MR
First Name:KAZI
Middle Name:M
Last Name:ANAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 38TH RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1318
Mailing Address - Country:US
Mailing Address - Phone:718-224-1209
Mailing Address - Fax:718-456-4983
Practice Address - Street 1:1472 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-3604
Practice Address - Country:US
Practice Address - Phone:718-381-0018
Practice Address - Fax:718-456-4983
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030417183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist