Provider Demographics
NPI:1316618424
Name:PINKHASOV, JOHNATHAN (PHARMD)
Entity type:Individual
Prefix:
First Name:JOHNATHAN
Middle Name:
Last Name:PINKHASOV
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SUNSET RD S
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1149
Mailing Address - Country:US
Mailing Address - Phone:516-606-4575
Mailing Address - Fax:
Practice Address - Street 1:40 SUNSET RD S
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-1149
Practice Address - Country:US
Practice Address - Phone:516-606-4575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist