Provider Demographics
NPI:1922388784
Name:SAKHAROV, ELIZABETH MELTSER (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MELTSER
Last Name:SAKHAROV
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 1:1660 E 14TH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1112
Mailing Address - Country:US
Mailing Address - Phone:718-382-8500
Mailing Address - Fax:718-382-4684
Practice Address - Street 1:1660 E 14TH ST STE 401
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1112
Practice Address - Country:US
Practice Address - Phone:718-382-8500
Practice Address - Fax:718-382-4684
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056132183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY056132OtherNEW YORK STATE LICENSE