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General NPI Number Information
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NPI Number | 1760893416
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Entity Type | Individual
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Provider Name | YANA BUKOVSKAYA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/15/2014
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 55 FRUIT ST GRB005
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City | BOSTON
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State | MA
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Zip | 02114-2621
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Country | US
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Telephone | 617-724-2416
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Fax |
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Provider Business Mailing Address
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Address Line | 44 WOODBRIDGE TER APT C
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-4276
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Country | US
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Telephone | 732-447-8201
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH234949
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License Number State | MA
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