Provider Demographics
NPI:1841699410
Name:IOURKIV, MARIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:IOURKIV
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 1:14007 REBECCA DR
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-1164
Mailing Address - Country:US
Mailing Address - Phone:215-776-0117
Mailing Address - Fax:
Practice Address - Street 1:12050 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-2108
Practice Address - Country:US
Practice Address - Phone:215-673-0937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPI113999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist