Provider Demographics
NPI:1457758385
Name:SEALY, HANIFF (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HANIFF
Middle Name:
Last Name:SEALY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 E FLORIDA ST APT 10
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88030-5366
Mailing Address - Country:US
Mailing Address - Phone:240-234-2783
Mailing Address - Fax:
Practice Address - Street 1:1021 E PINE ST
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-7009
Practice Address - Country:US
Practice Address - Phone:575-546-6746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist