Provider Demographics
NPI:1639733157
Name:IKHLAQ, SARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:IKHLAQ
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 1:44 RED FOX TRL
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-3710
Mailing Address - Country:US
Mailing Address - Phone:443-366-2075
Mailing Address - Fax:
Practice Address - Street 1:609 BERLIN CROSS KEYS RD STE D1
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-9535
Practice Address - Country:US
Practice Address - Phone:856-818-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2020-09-16
Deactivation Date:2019-07-30
Deactivation Code:
Reactivation Date:2020-09-16
Provider Licenses
StateLicense IDTaxonomies
MD26354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist