Healthcare Provider Details

I. General information

NPI: 1083986913
Provider Name (Legal Business Name): VALERIA DZIAMIOKHINA PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VALERIE DEMEKHIN PHARM.D.

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2677 COLBY CT APT 5K
BROOKLYN NY
11223-6127
US

IV. Provider business mailing address

2677 COLBY CT APT 5K
BROOKLYN NY
11223-6127
US

V. Phone/Fax

Practice location:
  • Phone: 347-404-2137
  • Fax:
Mailing address:
  • Phone: 347-404-2137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number056083
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: