MEDICARE: ALEXANDRA BABYLEVA

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	063274	NY

General Provider Information

NPI Number	:	1639688799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA BABYLEVA

Provider Business Mailing Address
First Line	:	1602 AVENUE W
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4419
Country	:	US
Telephone Number	:	718-300-0155
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-2093
Country	:	US
Telephone Number	:	718-627-9199
Fax Number	:

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

Provider Enumeration Date	:	09/21/2017
Last Update Date	:	09/21/2017

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Directions to “ ALEXANDRA BABYLEVA ” Practice Location

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