Provider Demographics
NPI:1063977601
Name:MERENKOV, ALEKSANDR (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ALEKSANDR
Middle Name:
Last Name:MERENKOV
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 WASHINGTON GDNS
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-2155
Mailing Address - Country:US
Mailing Address - Phone:413-250-2150
Mailing Address - Fax:
Practice Address - Street 1:2A WALTERS LN
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1613
Practice Address - Country:US
Practice Address - Phone:908-905-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI0399930183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist