Basic Information
Provider Information
NPI: 1174846224
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KHOSHKHARAMAN
FirstName: NAGHMEH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1877 E 12TH ST APT 3E
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112292700
CountryCode: US
TelephoneNumber: 7186045363
FaxNumber:  
Practice Location
Address1: 585 SCHENECTADY AVE
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112031809
CountryCode: US
TelephoneNumber: 7186045363
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/03/2010
LastUpdateDate: 03/03/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X5958919NYY Pharmacy Service ProvidersPharmacist 

No ID Information.


Home