Healthcare Provider Details

I. General information

NPI: 1285566893
Provider Name (Legal Business Name): FAIEZA ZINA KASSAB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 HIGHLAND RD
WATERFORD MI
48327-1915
US

IV. Provider business mailing address

38225 CAMERON DR
STERLING HEIGHTS MI
48310-3006
US

V. Phone/Fax

Practice location:
  • Phone: 248-673-4324
  • Fax:
Mailing address:
  • Phone: 248-417-6771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302418416
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: