Individual
KOOSHA BAMDAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 MIDDLE NECK RD, GREAT NECK, NY 11023-1245
(516) 730-8990
Mailing address
621 MIDDLE NECK RD, GREAT NECK, NY 11023-1245
(516) 730-8990
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
01/18/2022
Last updated
08/08/2022
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