Provider Demographics
NPI:1598047490
Name:HAILE, SENAIT
Entity Type:Individual
Prefix:MRS
First Name:SENAIT
Middle Name:
Last Name:HAILE
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 1:38 BOWERS ST APT 3
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-1424
Mailing Address - Country:US
Mailing Address - Phone:862-207-9716
Mailing Address - Fax:
Practice Address - Street 1:597 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3333
Practice Address - Country:US
Practice Address - Phone:973-450-0138
Practice Address - Fax:973-450-5970
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03259900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist