Provider Demographics
NPI:1831245604
Name:BAKOSS, LAMYAA (RPH)
Entity type:Individual
Prefix:MRS
First Name:LAMYAA
Middle Name:
Last Name:BAKOSS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 OVINGTON AVE
Mailing Address - Street 2:2E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1551
Mailing Address - Country:US
Mailing Address - Phone:718-780-5962
Mailing Address - Fax:
Practice Address - Street 1:428 OVINGTON AVE
Practice Address - Street 2:2E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1551
Practice Address - Country:US
Practice Address - Phone:718-780-5962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0470041835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology