Provider Demographics
NPI:1467032847
Name:KHALIQ, SOHAIB HAMZA (RPH)
Entity type:Individual
Prefix:DR
First Name:SOHAIB
Middle Name:HAMZA
Last Name:KHALIQ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BROOKSIDE AVE W
Mailing Address - Street 2:
Mailing Address - City:APALACHIN
Mailing Address - State:NY
Mailing Address - Zip Code:13732-4116
Mailing Address - Country:US
Mailing Address - Phone:607-744-0914
Mailing Address - Fax:
Practice Address - Street 1:9110 DUBLIN RD
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9588
Practice Address - Country:US
Practice Address - Phone:614-932-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist