Individual ProviderSusan MirzakandovPharmacistPharmacy Service ProvidersPractice Address121 Dekalb Ave, Brooklyn, NY 11201-5425(718) 250-8652PECOS EnrollmentBased on the most recent information from CMS, provider Susan Mirzakandov does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1972282929Provider TypeIndividualFull NameMirzakandov, SusanTitleDr.CredentialPHARMDGenderFemaleSole ProprietorNoEnumeration Date7/17/2023Last Updated7/17/2023Contact InformationPractice LocationPractice Address121 Dekalb Ave, Brooklyn, NY 11201-5425Phone(718) 250-8652FaxUnlisted FaxMailing LocationMailing Address4711 12th Ave Apt F11, Brooklyn, NY 11219-2532PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense069682New York