Provider Demographics
NPI:1740932003
Name:SALHAB, RAISAH (PHARMD)
Entity type:Individual
Prefix:
First Name:RAISAH
Middle Name:
Last Name:SALHAB
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 1:111 PARK ST APT 4M
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5450
Mailing Address - Country:US
Mailing Address - Phone:727-678-9335
Mailing Address - Fax:
Practice Address - Street 1:1100 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-1363
Practice Address - Country:US
Practice Address - Phone:203-747-3933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0015565183500000X
FLPS60625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist