Provider Demographics
NPI:1215241047
Name:ISHCHENKO, MAR'YANA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MAR'YANA
Middle Name:
Last Name:ISHCHENKO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MAR'YANA
Other - Middle Name:
Other - Last Name:MOSKALYUK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:800 DENOW RD STE F
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-5247
Mailing Address - Country:US
Mailing Address - Phone:609-737-9185
Mailing Address - Fax:609-737-9563
Practice Address - Street 1:800 DENOW RD STE F
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-5247
Practice Address - Country:US
Practice Address - Phone:609-737-9185
Practice Address - Fax:609-737-9563
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03333300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist