Provider Demographics
NPI:1023282498
Name:MEHJABEEN, SIFAT (PHARMD)
Entity type:Individual
Prefix:MS
First Name:SIFAT
Middle Name:
Last Name:MEHJABEEN
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 1:16430 HILLSIDE AVE
Mailing Address - Street 2:APT.# 14-H
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4100
Mailing Address - Country:US
Mailing Address - Phone:718-526-0404
Mailing Address - Fax:
Practice Address - Street 1:6535 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-5047
Practice Address - Country:US
Practice Address - Phone:718-520-6744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist