Provider Demographics
NPI:1447024880
Name:AGRANOVICH, ALEKSANDRA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALEKSANDRA
Middle Name:
Last Name:AGRANOVICH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ALEKSANDRA
Other - Middle Name:
Other - Last Name:AGRANOVICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOCTOR OF PHARMACY
Mailing Address - Street 1:800 POLY PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7104
Mailing Address - Country:US
Mailing Address - Phone:718-836-6600
Mailing Address - Fax:718-439-4166
Practice Address - Street 1:520 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-5426
Practice Address - Country:US
Practice Address - Phone:917-828-0545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty