Provider Demographics
NPI:1275881617
Name:SALJUKI, KAMRAN HUSSAINZADAH (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAMRAN
Middle Name:HUSSAINZADAH
Last Name:SALJUKI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 ELDEN ST
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4722
Mailing Address - Country:US
Mailing Address - Phone:703-796-6482
Mailing Address - Fax:703-796-6488
Practice Address - Street 1:603 ELDEN ST
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4722
Practice Address - Country:US
Practice Address - Phone:703-796-6482
Practice Address - Fax:703-796-6488
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211496183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist