MEDICARE: IGOR VINOKUR PHARM D

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	056210	NY

General Provider Information

NPI Number	:	1619250784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IGOR VINOKUR PHARM D

Provider Business Mailing Address
First Line	:	820 OCEAN PKWY APT 618
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2126
Country	:	US
Telephone Number	:	347-325-2702
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 OCEAN PKWY APT 618
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2126
Country	:	US
Telephone Number	:	347-325-2702
Fax Number	:

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

Provider Enumeration Date	:	09/24/2011
Last Update Date	:	09/24/2011

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Directions to “ IGOR VINOKUR PHARM D” Practice Location

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