Healthcare Provider Details

I. General information

NPI: 1851976799
Provider Name (Legal Business Name): IRYNA MIALIK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

IV. Provider business mailing address

3801 W NAPOLEON AVE APT B316
METAIRIE LA
70001-8604
US

V. Phone/Fax

Practice location:
  • Phone: 186-662-4763
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberPST.023618
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: