Provider Demographics
NPI:1033505052
Name:PASKOVATY, ALLA (PHARMD, BCPS AQID)
Entity Type:Individual
Prefix:
First Name:ALLA
Middle Name:
Last Name:PASKOVATY
Suffix:
Gender:F
Credentials:PHARMD, BCPS AQID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2676 E 24TH ST # 2A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2610
Mailing Address - Country:US
Mailing Address - Phone:518-265-2817
Mailing Address - Fax:
Practice Address - Street 1:1250 1ST AVE # 526
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6038
Practice Address - Country:US
Practice Address - Phone:212-639-7212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0484161835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist