Provider Demographics
NPI:1962645747
Name:HABASHI, LAILA
Entity Type:Individual
Prefix:MRS
First Name:LAILA
Middle Name:
Last Name:HABASHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 KENDALE PL
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48609-6792
Mailing Address - Country:US
Mailing Address - Phone:989-781-6244
Mailing Address - Fax:
Practice Address - Street 1:806 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-2171
Practice Address - Country:US
Practice Address - Phone:989-791-4221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035991183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist