Provider Demographics
NPI:1639456783
Name:MAKANJI, SAGAR (PHARM D)
Entity Type:Individual
Prefix:
First Name:SAGAR
Middle Name:
Last Name:MAKANJI
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 1:5065 MAIN STREET, STE TARGET
Mailing Address - Street 2:TARGET PHARMACY, STORE 2361
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611
Mailing Address - Country:US
Mailing Address - Phone:203-873-2014
Mailing Address - Fax:203-873-2024
Practice Address - Street 1:5065 MAIN STREET, STE TARGET
Practice Address - Street 2:TARGET PHARMACY, STORE 2361
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611
Practice Address - Country:US
Practice Address - Phone:203-873-2014
Practice Address - Fax:203-873-2024
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0011294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist