Provider Demographics
NPI:1275008666
Name:SAAD, SALLY
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:SAAD
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 1:2 RUE CHAGALL
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-2067
Mailing Address - Country:US
Mailing Address - Phone:609-334-5589
Mailing Address - Fax:
Practice Address - Street 1:2 RUE CHAGALL
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2067
Practice Address - Country:US
Practice Address - Phone:609-334-5589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03832000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist