Provider Demographics
NPI:1558618827
Name:HACK, NASEER A (RPH)
Entity Type:Individual
Prefix:
First Name:NASEER
Middle Name:A
Last Name:HACK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3508 SINGAPORE CIR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-5431
Mailing Address - Country:US
Mailing Address - Phone:505-730-9050
Mailing Address - Fax:505-727-9619
Practice Address - Street 1:3508 SINGAPORE CIR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-5431
Practice Address - Country:US
Practice Address - Phone:505-730-9050
Practice Address - Fax:505-727-9619
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP000053761835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric