Provider Demographics
NPI:1649209164
Name:ZAK, LILLY (PHARMD)
Entity type:Individual
Prefix:MS
First Name:LILLY
Middle Name:
Last Name:ZAK
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 1:1131 UNIVERSITY BLVD W
Mailing Address - Street 2:APT 414
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3357
Mailing Address - Country:US
Mailing Address - Phone:917-930-2681
Mailing Address - Fax:
Practice Address - Street 1:1131 UNIVERSITY BLVD W
Practice Address - Street 2:APT 414
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-3357
Practice Address - Country:US
Practice Address - Phone:917-930-2681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049853183500000X
MD23293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist