Healthcare Provider Details

I. General information

NPI: 1922388784
Provider Name (Legal Business Name): ELIZABETH MELTSER SAKHAROV PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2011
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 E 14TH ST STE 401
BROOKLYN NY
11229-1112
US

IV. Provider business mailing address

1660 E 14TH ST STE 401
BROOKLYN NY
11229-1112
US

V. Phone/Fax

Practice location:
  • Phone: 718-382-8500
  • Fax: 718-382-4684
Mailing address:
  • Phone: 718-382-8500
  • Fax: 718-382-4684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number056132
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: