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General NPI Number Information
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NPI Number | 1922313022
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Entity Type | Individual
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Provider Name | TATYANA RUVINOVA RPH
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Gender | Female
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 1 WHITEHALL ST
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City | NEW YORK
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State | NY
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Zip | 10004-2109
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Country | US
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Telephone | 212-509-9020
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Fax |
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Provider Business Mailing Address
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Address Line | 280 OCEAN PKWY
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City | BROOKLYN
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State | NY
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Zip | 11218-4056
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Country | US
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Telephone | 646-479-8049
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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 | 054853
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License Number State | NY
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