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General NPI Number Information
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NPI Number | 1194698555
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Entity Type | Individual
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Provider Name | HAFSA IMTIAZ
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Gender | Female
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | W156N11261 PILGRIM RD
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City | GERMANTOWN
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State | WI
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Zip | 53022-3420
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Country | US
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Telephone | 262-253-9720
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Fax |
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Provider Business Mailing Address
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Address Line | 11723 W BROWN DEER RD APT 102
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City | MILWAUKEE
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State | WI
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Zip | 53224-1447
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Country | US
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Telephone | 813-203-9740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 23212-40
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License Number State | WI
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