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General NPI Number Information
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NPI Number | 1114607538
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Entity Type | Individual
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Provider Name | INNA SAMANDAROVA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 378 NORTH AVE
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-4171
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Country | US
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Telephone | 917-632-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 14 STOKES RD APT 2B
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City | YONKERS
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State | NY
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Zip | 10710-5928
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Country | US
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Telephone | 617-852-9170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 056953
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License Number State | NY
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