Provider Demographics
NPI:1215259395
Name:SANKOVICH, ALLEN (RPH)
Entity type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:
Last Name:SANKOVICH
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 1:127 MINEOLA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3917
Mailing Address - Country:US
Mailing Address - Phone:516-746-4720
Mailing Address - Fax:516-741-1132
Practice Address - Street 1:127 MINEOLA BLVD
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3917
Practice Address - Country:US
Practice Address - Phone:516-746-4720
Practice Address - Fax:516-741-1132
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist