Provider Demographics
NPI:1124305776
Name:ATALLAH, SAAD I (RPH)
Entity type:Individual
Prefix:
First Name:SAAD
Middle Name:I
Last Name:ATALLAH
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 1:1 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:N.EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356
Mailing Address - Country:US
Mailing Address - Phone:781-228-1467
Mailing Address - Fax:
Practice Address - Street 1:1 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-2204
Practice Address - Country:US
Practice Address - Phone:781-228-1467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22058183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist