Provider Demographics
NPI:1609372580
Name:KOVAL, OLENA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:OLENA
Middle Name:
Last Name:KOVAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:OLENA
Other - Middle Name:
Other - Last Name:KOVAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:50 AIKEN ST APT 446
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-2037
Mailing Address - Country:US
Mailing Address - Phone:646-371-4260
Mailing Address - Fax:
Practice Address - Street 1:1606 BARNUM AVE
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-5301
Practice Address - Country:US
Practice Address - Phone:203-377-2851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-01
Last Update Date:2018-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0014273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist