Christina Ardelian, PHARMD

Individual provider Active NPI Pharmacist · Howard Beach, NY

NPI 1124665419 · NPPES record last updated Dec 5, 2019

Key facts

NPI
1124665419
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
064208 (NY)
Practice address
158-19 90TH Street
Howard Beach, NY 11414
Phone
(917) 675-2396
NPI assigned
Dec 5, 2019
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
064208NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Genoa Healthcare LLC Current
since Mar 9, 2020
Accepting new patients
Genoa Healthcare LLC Past
since Dec 9, 2019
Accepting new patients

Locations

9114 37th Ave
Ste E
Jackson Heights, NY 11372
Phone (718) 340-3658

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 064208 NY Yes

Addresses

Primary practice location

158-19 90TH Street
Howard Beach, NY 11414

Mailing address

9114 37TH Ave Ste E
Jackson Heights, NY 11372-7920
Phone (718) 340-3658

Other providers in Howard Beach, NY

All providers in Howard Beach, NY · Pharmacist in New York

Sources for this page

Verify at the official NPI Registry.