Provider Demographics
NPI:1588713424
Name:MLADINOV, ANTHONY (RPH)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:MLADINOV
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 1:87 SCARCLIFFE DR
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1049
Mailing Address - Country:US
Mailing Address - Phone:212-724-1950
Mailing Address - Fax:
Practice Address - Street 1:2260 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5403
Practice Address - Country:US
Practice Address - Phone:212-724-1950
Practice Address - Fax:212-724-1946
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist