Provider Demographics
NPI:1043632953
Name:ABDO, SAJEDA K (RPH)
Entity type:Individual
Prefix:MRS
First Name:SAJEDA
Middle Name:K
Last Name:ABDO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 E FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1105
Mailing Address - Country:US
Mailing Address - Phone:612-341-2273
Mailing Address - Fax:
Practice Address - Street 1:2711 E FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1105
Practice Address - Country:US
Practice Address - Phone:613-241-2273
Practice Address - Fax:612-341-2278
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-11
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121585183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN121585OtherPHARMACIST LICENSE