Provider Demographics
NPI:1215526801
Name:CHIZOR, IFY OLIVIA (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:IFY
Middle Name:OLIVIA
Last Name:CHIZOR
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10410 219TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-2021
Mailing Address - Country:US
Mailing Address - Phone:718-809-0731
Mailing Address - Fax:
Practice Address - Street 1:140 58TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2521
Practice Address - Country:US
Practice Address - Phone:212-920-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067414183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist