Provider Demographics
NPI:1699378810
Name:HANIF, WAHAJ (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WAHAJ
Middle Name:
Last Name:HANIF
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-3447
Mailing Address - Country:US
Mailing Address - Phone:347-981-8649
Mailing Address - Fax:
Practice Address - Street 1:5015 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-4468
Practice Address - Country:US
Practice Address - Phone:718-426-7572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist