MEDICARE: ANZHELLA ABRAMOV PHARMACIST

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
1	183500000X	Pharmacist	045826	NY

General Provider Information

NPI Number	:	1144499153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANZHELLA ABRAMOV PHARMACIST

Provider Business Mailing Address
First Line	:	6101 WOODHAVEN BLVD
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2738
Country	:	US
Telephone Number	:	718-424-7222
Fax Number	:	718-446-3192

Provider Business Practice Location Address
First Line	:	6101 WOODHAVEN BLVD
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2738
Country	:	US
Telephone Number	:	718-424-7222
Fax Number	:	718-446-3192

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2008
Last Update Date	:	02/23/2008

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