Provider Demographics
NPI:1124400973
Name:KIRAKOSYAN, ERIK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:KIRAKOSYAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 W MCDOWELL RD APT 1211
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-4814
Mailing Address - Country:US
Mailing Address - Phone:323-377-7643
Mailing Address - Fax:
Practice Address - Street 1:10350 W MCDOWELL RD APT 1211
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4814
Practice Address - Country:US
Practice Address - Phone:323-377-7643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-28
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS021119183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist