Provider Demographics
NPI:1114790144
Name:JILLANI, ZARNAB FATIMA
Entity Type:Individual
Prefix:
First Name:ZARNAB
Middle Name:FATIMA
Last Name:JILLANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZARNAB
Other - Middle Name:FATIMA
Other - Last Name:JILLANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3934 SKILLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11104-3707
Mailing Address - Country:US
Mailing Address - Phone:347-238-7659
Mailing Address - Fax:
Practice Address - Street 1:3934 SKILLMAN AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11104-3707
Practice Address - Country:US
Practice Address - Phone:347-238-7659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069524-01183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist