Provider Demographics
NPI:1447698741
Name:AKHTAR, TALHA ASEEM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TALHA
Middle Name:ASEEM
Last Name:AKHTAR
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 1:8532 126TH ST
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3313
Mailing Address - Country:US
Mailing Address - Phone:917-238-2203
Mailing Address - Fax:
Practice Address - Street 1:12202 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-2114
Practice Address - Country:US
Practice Address - Phone:718-843-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0565531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist