Individual
MR. EJAZ HASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3600 TIDEWATER DR, NORFOLK, VA 23509-1436
(757) 623-2706
(757) 623-5209
Mailing address
515 N MAIN ST, SUFFOLK, VA 23434-4426
(757) 539-9992
(757) 539-0810
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202209206
VA
Other
Enumeration date
07/06/2010
Last updated
05/18/2013
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