MEDICARE: TATYANA LABOVSKAYA 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
1	183500000X	Pharmacist	RP450125	PA

General Provider Information

NPI Number	:	1831549062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TATYANA LABOVSKAYA PHARMD.

Provider Business Mailing Address
First Line	:	2017 S BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-5505
Country	:	US
Telephone Number	:	215-467-0850
Fax Number	:

Provider Business Practice Location Address
First Line	:	2017 S BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-5505
Country	:	US
Telephone Number	:	215-467-0850
Fax Number	:

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

Provider Enumeration Date	:	06/19/2016
Last Update Date	:	06/19/2016

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Directions to “ TATYANA LABOVSKAYA PHARMD.” Practice Location

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