Provider Demographics
NPI:1114518057
Name:HASAN, ZEHRA (RPH)
Entity Type:Individual
Prefix:
First Name:ZEHRA
Middle Name:
Last Name:HASAN
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 1:22466 PINE TOP CT
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-6933
Mailing Address - Country:US
Mailing Address - Phone:703-926-6939
Mailing Address - Fax:
Practice Address - Street 1:510 BLACKWELL RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2600
Practice Address - Country:US
Practice Address - Phone:540-347-1621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA020226467183500000X
VA0202206467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist