Provider Demographics
NPI:1861528036
Name:GHAURI, WAHEED U (RPH)
Entity type:Individual
Prefix:MR
First Name:WAHEED
Middle Name:U
Last Name:GHAURI
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 1:2 FLEETWOOD RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-1756
Mailing Address - Country:US
Mailing Address - Phone:631-269-7721
Mailing Address - Fax:
Practice Address - Street 1:3395 GREAT NECK RD
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-1912
Practice Address - Country:US
Practice Address - Phone:631-841-3091
Practice Address - Fax:631-841-1375
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031656183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist