Healthcare Provider Details

I. General information

NPI: 1467952473
Provider Name (Legal Business Name): RACHEL BRODSKIY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2018
Last Update Date: 02/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8910 JAMAICA AVE
WOODHAVEN NY
11421-2040
US

IV. Provider business mailing address

2227 E 70TH ST
BROOKLYN NY
11234-6505
US

V. Phone/Fax

Practice location:
  • Phone: 718-849-7777
  • Fax:
Mailing address:
  • Phone: 646-346-9584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number063497
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: