Healthcare Provider Details

I. General information

NPI: 1154253060
Provider Name (Legal Business Name): NATALIE ESHAGHIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 CONEY ISLAND AVE
BROOKLYN NY
11230-4714
US

IV. Provider business mailing address

45 WARWICK RD
GREAT NECK NY
11023-1613
US

V. Phone/Fax

Practice location:
  • Phone: 718-253-4900
  • Fax: 718-253-4905
Mailing address:
  • Phone: 516-445-6265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number071130-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: