Provider Demographics
NPI:1699098871
Name:SAZAN, DAVID (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SAZAN
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 1:6255 BROADWAY
Mailing Address - Street 2:SUITE 6C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3128
Mailing Address - Country:US
Mailing Address - Phone:718-796-1022
Mailing Address - Fax:
Practice Address - Street 1:6255 BROADWAY
Practice Address - Street 2:SUITE 6C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-3128
Practice Address - Country:US
Practice Address - Phone:718-796-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist