Provider Demographics
NPI:1740534015
Name:PAYDAWY, TANIA SADIQ (PHARMD)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:SADIQ
Last Name:PAYDAWY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5328 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-4035
Mailing Address - Country:US
Mailing Address - Phone:517-285-5301
Mailing Address - Fax:
Practice Address - Street 1:1815 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-4136
Practice Address - Country:US
Practice Address - Phone:248-546-6572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist