Provider Demographics
NPI:1881115939
Name:IROKU, ELIZABETH N (RPH MS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:N
Last Name:IROKU
Suffix:
Gender:F
Credentials:RPH MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3714 CLARENDON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5129
Mailing Address - Country:US
Mailing Address - Phone:718-856-7465
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 36
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-0036
Practice Address - Country:US
Practice Address - Phone:718-270-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041779-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist