Provider Demographics
NPI:1225392962
Name:ROY, SAJAL (PHARMD, CGP, CPSO)
Entity type:Individual
Prefix:DR
First Name:SAJAL
Middle Name:
Last Name:ROY
Suffix:
Gender:M
Credentials:PHARMD, CGP, CPSO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 HAWTHORNE HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-9341
Mailing Address - Country:US
Mailing Address - Phone:570-977-0097
Mailing Address - Fax:
Practice Address - Street 1:518 PUJO ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-4365
Practice Address - Country:US
Practice Address - Phone:337-761-5397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20596183500000X
NY052265-1183500000X
PARP439476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist