Provider Demographics
NPI:1003124918
Name:ISKHAKOVA, DIANA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:ISKHAKOVA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8105 190TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1040
Mailing Address - Country:US
Mailing Address - Phone:347-678-6032
Mailing Address - Fax:
Practice Address - Street 1:535 5TH AVE
Practice Address - Street 2:DUANE READE PHARMACY
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-687-8641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055094183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist