Healthcare Provider Details

I. General information

NPI: 1588865596
Provider Name (Legal Business Name): ALEKSEY ZATSEPILO PHARMACIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 FOSTER AVE
BROOKLYN NY
11230-1809
US

IV. Provider business mailing address

2740 CROPSEY AVE APT 7G
BROOKLYN NY
11214-6829
US

V. Phone/Fax

Practice location:
  • Phone: 718-724-1717
  • Fax: 718-859-4600
Mailing address:
  • Phone: 718-724-1717
  • Fax: 718-859-4688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number049590
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: