Provider Demographics
NPI:1114302759
Name:AZARKIAN, EVELYN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:AZARKIAN
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 1:1 ASPEN PL
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2810
Mailing Address - Country:US
Mailing Address - Phone:516-383-5960
Mailing Address - Fax:
Practice Address - Street 1:1 ASPEN PL
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2810
Practice Address - Country:US
Practice Address - Phone:516-383-5960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist