Provider Demographics
NPI:1154679496
Name:ALKADA, EILY (PHARMD)
Entity Type:Individual
Prefix:
First Name:EILY
Middle Name:
Last Name:ALKADA
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 1:1316 AVENUE T
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3316
Mailing Address - Country:US
Mailing Address - Phone:646-338-8795
Mailing Address - Fax:718-438-7353
Practice Address - Street 1:380 KNICKERBOCKER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-3702
Practice Address - Country:US
Practice Address - Phone:718-676-9976
Practice Address - Fax:718-676-9986
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057132183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY057132OtherBOARD OF PHARMACY