Provider Demographics
NPI:1932684826
Name:SHIMONOV, ESTHER (PHARMD RPH)
Entity Type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:
Last Name:SHIMONOV
Suffix:
Gender:F
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6360 102ND ST APT B11
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2433
Mailing Address - Country:US
Mailing Address - Phone:917-623-3512
Mailing Address - Fax:
Practice Address - Street 1:6360 102ND ST APT B11
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2433
Practice Address - Country:US
Practice Address - Phone:917-623-3512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist