Provider Demographics
NPI:1265003271
Name:GLLOXHANI, EDONA (PHARMD)
Entity Type:Individual
Prefix:
First Name:EDONA
Middle Name:
Last Name:GLLOXHANI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:EDONA
Other - Middle Name:
Other - Last Name:KELMENDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7502 RIDGE BLVD APT B4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2938
Mailing Address - Country:US
Mailing Address - Phone:917-902-6016
Mailing Address - Fax:
Practice Address - Street 1:530 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-5101
Practice Address - Country:US
Practice Address - Phone:212-687-8641
Practice Address - Fax:212-687-8645
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI-067422-01183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist