Provider Demographics
NPI:1093291072
Name:METZGER, ILONA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ILONA
Middle Name:
Last Name:METZGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 W 5TH ST APT 21G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3980
Mailing Address - Country:US
Mailing Address - Phone:917-623-9877
Mailing Address - Fax:718-332-2247
Practice Address - Street 1:2925 W 5TH ST APT 21G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3980
Practice Address - Country:US
Practice Address - Phone:917-623-9877
Practice Address - Fax:718-332-2247
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064120183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist