MEDICARE: PAVEL VOLYNSKY RPH

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	056174	NY

General Provider Information

NPI Number	:	1528349867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAVEL VOLYNSKY RPH

Provider Business Mailing Address
First Line	:	7020 ROCKAWAY BEACH BLVD
Second Line	:
City	:	ARVERNE
State	:	NY
Zip	:	11692-1272
Country	:	US
Telephone Number	:	718-318-6285
Fax Number	:	718-318-6440

Provider Business Practice Location Address
First Line	:	7020 ROCKAWAY BEACH BLVD
Second Line	:
City	:	ARVERNE
State	:	NY
Zip	:	11692-1272
Country	:	US
Telephone Number	:	718-318-6285
Fax Number	:	718-318-6440

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

Provider Enumeration Date	:	08/31/2011
Last Update Date	:	08/31/2011

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