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General NPI Number Information
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NPI Number | 1629565320
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Entity Type | Organization
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Legal Business Name | STASHONAK CLINICAL PHARMACY SERVICES AND CONSULTING
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 04/18/2018
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Provider Practice Location Address
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Address Line | 2814 AVENUE X
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City | BROOKLYN
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State | NY
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Zip | 11235-1904
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Country | US
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Telephone | 718-664-4990
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Fax |
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Provider Business Mailing Address
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Address Line | 2814 AVENUE X
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City | BROOKLYN
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State | NY
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Zip | 11235-1904
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Country | US
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Telephone | 718-664-4990
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Fax |
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Authorized Official
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Title or Position | MEDICATION RISK MANAGEMENT
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Name | DR. ANDREI STASHONAK
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Credential | MS, PHARMD
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Telephone | 718-664-4990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 055299
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License Number State | NY
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