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General NPI Number Information
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NPI Number | 1861476384
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Entity Type | Organization
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Legal Business Name | EVE 4 PHARMACY
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 1634 BROADWAY
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City | BROOKLYN
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State | NY
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Zip | 11207-1026
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Country | US
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Telephone | 718-573-5555
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Fax | 718-573-3240
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Provider Business Mailing Address
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Address Line | 1634 BROADWAY
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City | BROOKLYN
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State | NY
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Zip | 11207-1026
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Country | US
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Telephone | 718-573-5555
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Fax | 718-573-3240
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ALLA SHIKHMAN
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Credential | PHD
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Telephone | 718-743-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 026094
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License Number State | NY
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