Healthcare Provider Details

I. General information

NPI: 1790963981
Provider Name (Legal Business Name): MRS. ILONA VAKOR-SANDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2008
Last Update Date: 10/26/2024
Certification Date: 10/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8515 BAY PKWY
BROOKLYN NY
11214-3771
US

IV. Provider business mailing address

295 AVENUE P APT 6C
BROOKLYN NY
11204-4178
US

V. Phone/Fax

Practice location:
  • Phone: 718-266-6160
  • Fax: 718-266-6268
Mailing address:
  • Phone: 917-613-1904
  • Fax: 718-266-6268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number050008
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: