Provider Demographics
NPI:1225619315
Name:SYEDA, ASFIYA BATOOL (CPTH)
Entity Type:Individual
Prefix:
First Name:ASFIYA BATOOL
Middle Name:
Last Name:SYEDA
Suffix:
Gender:F
Credentials:CPTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4708 BURMA RD
Mailing Address - Street 2:
Mailing Address - City:MCFARLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53558-9499
Mailing Address - Country:US
Mailing Address - Phone:608-852-9770
Mailing Address - Fax:
Practice Address - Street 1:2101 ROYAL AVE
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53713-4812
Practice Address - Country:US
Practice Address - Phone:608-226-8671
Practice Address - Fax:608-226-8674
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI30121628183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician