Provider Demographics
NPI:1841461068
Name:WILKIN, EVA (RPH)
Entity type:Individual
Prefix:MRS
First Name:EVA
Middle Name:
Last Name:WILKIN
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 1:271 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4502
Mailing Address - Country:US
Mailing Address - Phone:516-496-9452
Mailing Address - Fax:516-496-9464
Practice Address - Street 1:271 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4502
Practice Address - Country:US
Practice Address - Phone:516-496-9452
Practice Address - Fax:516-496-9464
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist