Provider Demographics
NPI:1447431770
Name:PLAVNIKOVA, ALLA I (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ALLA
Middle Name:I
Last Name:PLAVNIKOVA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3629 STALKER RD
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-9362
Mailing Address - Country:US
Mailing Address - Phone:585-377-9054
Mailing Address - Fax:
Practice Address - Street 1:2172 PENFIELD RD
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1736
Practice Address - Country:US
Practice Address - Phone:585-388-9410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist