Provider Demographics
NPI:1467722611
Name:HAAZ, ELLIOTT ROBERT (BS, RPH)
Entity Type:Individual
Prefix:MR
First Name:ELLIOTT
Middle Name:ROBERT
Last Name:HAAZ
Suffix:
Gender:M
Credentials:BS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 MERIDIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976
Mailing Address - Country:US
Mailing Address - Phone:267-483-8554
Mailing Address - Fax:
Practice Address - Street 1:1 YORKTOWN PLZ
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1400
Practice Address - Country:US
Practice Address - Phone:215-481-9562
Practice Address - Fax:215-481-9675
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP028039L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist