Provider Demographics
NPI:1114103488
Name:SULEHRI, HUMAIRA FIRDOS
Entity Type:Individual
Prefix:
First Name:HUMAIRA
Middle Name:FIRDOS
Last Name:SULEHRI
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 1:9 STEINBERG AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2127
Mailing Address - Country:US
Mailing Address - Phone:973-928-5247
Mailing Address - Fax:
Practice Address - Street 1:3206 MERMAID AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1810
Practice Address - Country:US
Practice Address - Phone:718-996-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist