Provider Demographics
NPI:1023833282
Name:AKTHER, POLLOBI
Entity type:Individual
Prefix:
First Name:POLLOBI
Middle Name:
Last Name:AKTHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TERRY LN
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2620
Mailing Address - Country:US
Mailing Address - Phone:347-303-5275
Mailing Address - Fax:
Practice Address - Street 1:1297 A GRAND AVE
Practice Address - Street 2:
Practice Address - City:BLADWIN
Practice Address - State:NY
Practice Address - Zip Code:11510
Practice Address - Country:US
Practice Address - Phone:516-272-7990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071424183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist