Provider Demographics
NPI:1164741203
Name:SONBOLIAN, NINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:SONBOLIAN
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 1:1449 1ST AVE
Mailing Address - Street 2:RAINBOW PHARMACY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3002
Mailing Address - Country:US
Mailing Address - Phone:212-535-7100
Mailing Address - Fax:212-535-7101
Practice Address - Street 1:1449 1ST AVE
Practice Address - Street 2:RAINBOW PHARMACY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3002
Practice Address - Country:US
Practice Address - Phone:212-535-7100
Practice Address - Fax:212-535-7101
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053597183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist