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NPI Code Detail

MEDICARE: MS. NATELLA MALLAYEVA PHARMD

MEDICARE:  MS. NATELLA  MALLAYEVA  PHARMD
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
1183500000XPharmacist057231NY

General Provider Information

NPI Number : 1053660183
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NATELLA MALLAYEVA PHARMD
Provider Business Mailing Address
First Line : 6730 CLYDE ST APT 4K
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-4010
Country : US
Telephone Number : 718-520-2633
Fax Number :
Provider Business Practice Location Address
First Line : 4021 13TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-3564
Country : US
Telephone Number : 718-633-4377
Fax Number : 718-633-4378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2012
Last Update Date : 09/05/2012

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Directions to “ MS. NATELLA MALLAYEVA PHARMD” Practice Location

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