Healthcare Provider Details

I. General information

NPI: 1972820413
Provider Name (Legal Business Name): YURY SHEKHTER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 ROUTE 73
VOORHEES NJ
08043-9532
US

IV. Provider business mailing address

91 ROUTE 73
VOORHEES NJ
08043-9532
US

V. Phone/Fax

Practice location:
  • Phone: 856-768-1801
  • Fax:
Mailing address:
  • Phone: 856-768-1801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02504700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: