Provider Demographics
NPI:1881851459
Name:LAKHTER, MAKSIM (PHARM D)
Entity Type:Individual
Prefix:
First Name:MAKSIM
Middle Name:
Last Name:LAKHTER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2679 E 24TH ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2669
Mailing Address - Country:US
Mailing Address - Phone:718-578-8016
Mailing Address - Fax:
Practice Address - Street 1:4277 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5709
Practice Address - Country:US
Practice Address - Phone:516-796-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051350183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6131850001Medicare NSC