Provider Demographics
NPI:1124268743
Name:ALKADA, MARCO (RPH)
Entity type:Individual
Prefix:
First Name:MARCO
Middle Name:
Last Name:ALKADA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4723 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2602
Mailing Address - Country:US
Mailing Address - Phone:718-438-6555
Mailing Address - Fax:718-438-7353
Practice Address - Street 1:4723 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2602
Practice Address - Country:US
Practice Address - Phone:718-438-6555
Practice Address - Fax:718-438-7353
Is Sole Proprietor?:No
Enumeration Date:2009-02-22
Last Update Date:2009-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046058183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist