Provider Demographics
NPI:1073218921
Name:ANAAM, SABA M
Entity Type:Individual
Prefix:
First Name:SABA
Middle Name:M
Last Name:ANAAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:987 W SIDE AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-6903
Mailing Address - Country:US
Mailing Address - Phone:954-397-3600
Mailing Address - Fax:
Practice Address - Street 1:1097 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4126
Practice Address - Country:US
Practice Address - Phone:201-436-6831
Practice Address - Fax:201-436-4782
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RW03586800183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician