Provider Demographics
NPI:1609266444
Name:SEGUSULAIMAN-RIYAZ, HAYRUN NISHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HAYRUN
Middle Name:NISHA
Last Name:SEGUSULAIMAN-RIYAZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 45TH AVE APT 5N
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3517
Mailing Address - Country:US
Mailing Address - Phone:646-438-3426
Mailing Address - Fax:
Practice Address - Street 1:8111 45TH AVE APT 5N
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3517
Practice Address - Country:US
Practice Address - Phone:646-438-3426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03671600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist