Provider Demographics
NPI:1710697636
Name:MIRZA, FIZZAH QADAR (PHARM D)
Entity Type:Individual
Prefix:
First Name:FIZZAH
Middle Name:QADAR
Last Name:MIRZA
Suffix:
Gender:F
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 1:25 GENESIS ST
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-9031
Mailing Address - Country:US
Mailing Address - Phone:732-513-8828
Mailing Address - Fax:
Practice Address - Street 1:4008 ROUTE 9 N
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1577
Practice Address - Country:US
Practice Address - Phone:732-970-1225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04270600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist