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General NPI Number Information
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NPI Number | 1558102152
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Entity Type | Individual
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Provider Name | NATALI KALANTAROV PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 5411 MYRTLE AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-3452
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Country | US
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Telephone | 718-386-6692
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Fax |
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Provider Business Mailing Address
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Address Line | 13602 ROOSEVELT AVE
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City | FLUSHING
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State | NY
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Zip | 11354-5510
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Country | US
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Telephone | 718-886-3212
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Fax | 718-886-9195
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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 | 071475
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License Number State | NY
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