Provider Demographics
NPI:1245949551
Name:IRSHAD, SABA
Entity type:Individual
Prefix:
First Name:SABA
Middle Name:
Last Name:IRSHAD
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 1:131 HUBER ST
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-4221
Mailing Address - Country:US
Mailing Address - Phone:551-241-2659
Mailing Address - Fax:
Practice Address - Street 1:440 BELLEVILLE TPKE
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6719
Practice Address - Country:US
Practice Address - Phone:551-241-2659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RJ13677183500000X
NJ28RI04258300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist