Provider Demographics
NPI:1568042265
Name:AZIZ, SANA SAAD
Entity Type:Individual
Prefix:
First Name:SANA
Middle Name:SAAD
Last Name:AZIZ
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 1:3481 LAKESIDE DR NE APT 1807
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1321
Mailing Address - Country:US
Mailing Address - Phone:773-681-4466
Mailing Address - Fax:
Practice Address - Street 1:3481 LAKESIDE DR NE APT 1807
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1321
Practice Address - Country:US
Practice Address - Phone:773-681-4466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist