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General NPI Number Information
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NPI Number | 1952188625
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Entity Type | Individual
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Provider Name | JENNIFER TOMA IFRAIMOV
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Gender | Female
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 2151 86TH ST
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City | BROOKLYN
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State | NY
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Zip | 11214-3205
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Country | US
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Telephone | 718-299-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 2315 82ND ST APT 2
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City | BROOKLYN
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State | NY
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Zip | 11214-2725
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Country | US
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Telephone | 917-539-2313
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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 | 070761
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License Number State | NY
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