Individual
MIRIT A FAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1 VERMONT DR, NEW HYDE PARK, NY 11042-1128
(877) 501-0108
Mailing address
1 VERMONT DR, NEW HYDE PARK, NY 11042-1128
(877) 501-0108
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
055204-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055204-1
PHARMACIST LICENSE
NY
01
—
28RI03247400
PHARMACIST LICENSE
NJ
Enumeration date
09/13/2017
Last updated
07/21/2022
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