Provider Demographics
NPI:1861716383
Name:SHAREEF, SADATH ULLA (BPHARM; MTECH)
Entity type:Individual
Prefix:MR
First Name:SADATH
Middle Name:ULLA
Last Name:SHAREEF
Suffix:
Gender:M
Credentials:BPHARM; MTECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 KEW AVE
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1415
Mailing Address - Country:US
Mailing Address - Phone:718-381-3622
Mailing Address - Fax:718-381-7992
Practice Address - Street 1:389 ONDERDONK AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1336
Practice Address - Country:US
Practice Address - Phone:718-381-3622
Practice Address - Fax:718-381-7992
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2011-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053290183500000X
NJ28RI03135200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist