Healthcare Provider Details

I. General information

NPI: 1578499182
Provider Name (Legal Business Name): MILANA MUSAYEVA PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 LAKEVILLE RD
NEW HYDE PARK NY
11040-3052
US

IV. Provider business mailing address

8148 189TH ST
HOLLIS NY
11423-1037
US

V. Phone/Fax

Practice location:
  • Phone: 516-960-5161
  • Fax:
Mailing address:
  • Phone: 347-870-5763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number073929
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: