Provider Demographics
NPI:1578047296
Name:MEHIRDEL, SANAULLAH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SANAULLAH
Middle Name:
Last Name:MEHIRDEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15036 20TH RD FL 1
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3602
Mailing Address - Country:US
Mailing Address - Phone:718-223-3692
Mailing Address - Fax:
Practice Address - Street 1:2112 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-1404
Practice Address - Country:US
Practice Address - Phone:718-597-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist