Individual
TATIANA LASTOVKINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3185 DEMING WAY, MIDDLETON, WI 53562-1435
(608) 263-1292
Mailing address
215 ALEXANDER AVE, HOWELL, NJ 07731-8681
(347) 834-6643
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI04213500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
N/A
NJ
Enumeration date
01/13/2022
Last updated
06/22/2025
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