Provider Demographics
NPI:1013576917
Name:SAWERS, BASSEM FAYEZ RAGHEB
Entity Type:Individual
Prefix:
First Name:BASSEM
Middle Name:FAYEZ RAGHEB
Last Name:SAWERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 HARRIMAN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:NY
Mailing Address - Zip Code:10926-3505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:89 HARRIMAN WOODS DR
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:NY
Practice Address - Zip Code:10926-3505
Practice Address - Country:US
Practice Address - Phone:917-755-1466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04019200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist