Provider Demographics
NPI:1962559948
Name:SUFIAN, HUDA (RPH)
Entity type:Individual
Prefix:MS
First Name:HUDA
Middle Name:
Last Name:SUFIAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 N WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1113
Mailing Address - Country:US
Mailing Address - Phone:856-346-1122
Mailing Address - Fax:856-346-1667
Practice Address - Street 1:404 N WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1113
Practice Address - Country:US
Practice Address - Phone:856-346-1122
Practice Address - Fax:856-346-1667
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02257100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02257100OtherPHARMACY LICENSE NUMBER