Individual
IRINA MINKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
9977 BUSTLETON AVE, PHILADELPHIA, PA 19115-1557
(215) 677-0100
Mailing address
9977 BUSTLETON AVE, PHILADELPHIA, PA 19115-1557
(215) 677-0100
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP044280L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP044280L
STATE LICENSE
PA
Enumeration date
03/28/2007
Last updated
07/08/2007
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