Provider Demographics
NPI:1477876316
Name:PANDZIC, NANCY (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:PANDZIC
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1831
Mailing Address - Country:US
Mailing Address - Phone:631-739-3812
Mailing Address - Fax:
Practice Address - Street 1:40 W 225TH ST
Practice Address - Street 2:T-1798
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-7016
Practice Address - Country:US
Practice Address - Phone:718-733-6927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-07
Last Update Date:2010-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist