Provider Demographics
NPI:1649047168
Name:HAQUE, SAJJAD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SAJJAD
Middle Name:
Last Name:HAQUE
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 1:25505 ACORN LN
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-3493
Mailing Address - Country:US
Mailing Address - Phone:845-558-4613
Mailing Address - Fax:
Practice Address - Street 1:22898 SUSSEX HWY
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-5852
Practice Address - Country:US
Practice Address - Phone:302-628-6100
Practice Address - Fax:302-628-6108
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0015997183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist