Healthcare Provider Details

I. General information

NPI: 1689140204
Provider Name (Legal Business Name): SHIRIN ZIRKIEVA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15802 UNION TPKE
FLUSHING NY
11366-1940
US

IV. Provider business mailing address

8267 166TH ST
JAMAICA NY
11432-1820
US

V. Phone/Fax

Practice location:
  • Phone: 718-380-8259
  • Fax:
Mailing address:
  • Phone: 718-415-0982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number064884
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: