Provider Demographics
NPI:1760776389
Name:JANKOWSKI, HALINA JOSEPHINE (RPH)
Entity Type:Individual
Prefix:
First Name:HALINA
Middle Name:JOSEPHINE
Last Name:JANKOWSKI
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 1:559 DRIGGS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-2911
Mailing Address - Country:US
Mailing Address - Phone:718-387-6566
Mailing Address - Fax:718-782-7101
Practice Address - Street 1:559 DRIGGS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-2911
Practice Address - Country:US
Practice Address - Phone:718-387-6566
Practice Address - Fax:718-782-7101
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY037779OtherLICENSE