Provider Demographics
NPI:1659533651
Name:HUSSAIN, IFTIKHAR (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:IFTIKHAR
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1857 HOLDENS ARBOR RUN
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2004
Mailing Address - Country:US
Mailing Address - Phone:440-835-8682
Mailing Address - Fax:
Practice Address - Street 1:16207 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-3784
Practice Address - Country:US
Practice Address - Phone:216-521-8826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-19577183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist