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NPI Code Detail

MEDICARE: SVETLANA SHLYAM

MEDICARE:   SVETLANA  SHLYAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist047190-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003093766
Entity Type Code : Individual
Provider Name (Legal Business Name) : SVETLANA SHLYAM
Provider Business Mailing Address
First Line : 10202 FLATLANDS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-2810
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2202 AVENUE U
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-3648
Country : US
Telephone Number : 347-462-4562
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2008
Last Update Date : 03/09/2022

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Directions to “ SVETLANA SHLYAM ” Practice Location

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