MEDICARE: TIMUR YUZEFPOLSKIY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	065314	NY

General Provider Information

NPI Number	:	1104481167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMUR YUZEFPOLSKIY

Provider Business Mailing Address
First Line	:	1211 FOSTER AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1607
Country	:	US
Telephone Number	:	718-421-0099
Fax Number	:	718-421-0089

Provider Business Practice Location Address
First Line	:	1211 FOSTER AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1607
Country	:	US
Telephone Number	:	718-421-0099
Fax Number	:	718-421-0089

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2019
Last Update Date	:	08/03/2024

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Directions to “ TIMUR YUZEFPOLSKIY ” Practice Location

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