Provider Demographics
NPI:1437345626
Name:KANMAZ, TINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:
Last Name:KANMAZ
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:ST JOHN'S UNIVERSITY ST ALBERT'S HALL RM 114
Mailing Address - Street 2:8000 UTOPIA PARKWAY
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11439-0001
Mailing Address - Country:US
Mailing Address - Phone:718-990-5243
Mailing Address - Fax:718-990-1986
Practice Address - Street 1:ST JOHN'S UNIVERSITY ST ALBERT'S HALL RM 114
Practice Address - Street 2:8000 UTOPIA PARKWAY
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11439-0001
Practice Address - Country:US
Practice Address - Phone:718-990-5243
Practice Address - Fax:718-990-1986
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042324-11835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy