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NPI Code Detail

MEDICARE: ELLA BEREZOVSKI PHARMD

MEDICARE: ELLA BEREZOVSKI PHARMD
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
1183500000XPharmacist060851NY

General Provider Information

NPI Number : 1760859094
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLA BEREZOVSKI PHARMD
Provider Business Mailing Address
First Line : 555 BRITTON AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10304-4523
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2201 BATH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-5603
Country : US
Telephone Number : 718-372-0797
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2015
Last Update Date : 08/29/2015

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Directions to “ ELLA BEREZOVSKI PHARMD” Practice Location

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