Healthcare Provider Details

I. General information

NPI: 1225619315
Provider Name (Legal Business Name): ASFIYA BATOOL SYEDA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 STATE HIGHWAY 138
STOUGHTON WI
53589
US

IV. Provider business mailing address

2600 STATE HIGHWAY 138
STOUGHTON WI
53589
US

V. Phone/Fax

Practice location:
  • Phone: 606-873-9262
  • Fax:
Mailing address:
  • Phone: 606-873-9262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2315940
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: