Provider Demographics
NPI:1639535123
Name:LALEHZAR, LINDA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:LALEHZAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:ROSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:68 OLD POND RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1032
Mailing Address - Country:US
Mailing Address - Phone:917-428-1514
Mailing Address - Fax:
Practice Address - Street 1:68 OLD POND RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1032
Practice Address - Country:US
Practice Address - Phone:917-428-1514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0483971835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist