Provider Demographics
NPI:1225581648
Name:AKHTAR, WALAA B
Entity Type:Individual
Prefix:
First Name:WALAA
Middle Name:B
Last Name:AKHTAR
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 1:10 WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1923
Mailing Address - Country:US
Mailing Address - Phone:603-627-2496
Mailing Address - Fax:603-627-2852
Practice Address - Street 1:10 WHITEHALL RD
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1923
Practice Address - Country:US
Practice Address - Phone:603-627-2496
Practice Address - Fax:603-627-2852
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist