Provider Demographics
NPI:1780869784
Name:SAHAK, ZAKIA A
Entity type:Individual
Prefix:MRS
First Name:ZAKIA
Middle Name:A
Last Name:SAHAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10309 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-1728
Mailing Address - Country:US
Mailing Address - Phone:718-659-9621
Mailing Address - Fax:718-659-9626
Practice Address - Street 1:24946 HORACE HARDING EXPY
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11362-2050
Practice Address - Country:US
Practice Address - Phone:718-747-0180
Practice Address - Fax:718-747-0186
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02058946Medicaid