Provider Demographics
NPI:1588209878
Name:ISKHAKOVA, ANGELINA (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:ISKHAKOVA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:ANGELINA
Other - Middle Name:
Other - Last Name:ISKHAKOVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:7343 177TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1520
Mailing Address - Country:US
Mailing Address - Phone:347-828-4467
Mailing Address - Fax:
Practice Address - Street 1:310 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2525
Practice Address - Country:US
Practice Address - Phone:347-828-4467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065733183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist