Healthcare Provider Details

I. General information

NPI: 1891264610
Provider Name (Legal Business Name): VOLHA BUKINICH DR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2018
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1242 FLATBUSH AVE
BROOKLYN NY
11226-7619
US

IV. Provider business mailing address

2940 OCEAN PKWY APT 20E
BROOKLYN NY
11235-8251
US

V. Phone/Fax

Practice location:
  • Phone: 718-941-2669
  • Fax:
Mailing address:
  • Phone: 718-200-4153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number064579
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: