Provider Demographics
NPI:1508096280
Name:NALABOFF, VANESSA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:
Last Name:NALABOFF
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 1:705 E 187TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-6803
Mailing Address - Country:US
Mailing Address - Phone:718-364-6100
Mailing Address - Fax:718-365-6421
Practice Address - Street 1:705 E 187TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-6803
Practice Address - Country:US
Practice Address - Phone:718-364-6100
Practice Address - Fax:718-365-6421
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044574183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist