Provider Demographics
NPI:1871244053
Name:AMINOV, ELAINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:AMINOV
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18441 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1515
Mailing Address - Country:US
Mailing Address - Phone:917-331-6760
Mailing Address - Fax:
Practice Address - Street 1:18441 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1515
Practice Address - Country:US
Practice Address - Phone:917-331-6760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist