Provider Demographics
NPI:1184879314
Name:HAJ, CYNTHIA A
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:HAJ
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 1:1595 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14546-9746
Mailing Address - Country:US
Mailing Address - Phone:585-889-2229
Mailing Address - Fax:
Practice Address - Street 1:1595 NORTH RD
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14546-9746
Practice Address - Country:US
Practice Address - Phone:585-889-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist