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NPI Code Detail

MEDICARE: MS. NADEZHDA YEVDAYEVA PHARMD

MEDICARE: MS. NADEZHDA YEVDAYEVA 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
1183500000XPharmacist061769-1NY

General Provider Information

NPI Number : 1205381704
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NADEZHDA YEVDAYEVA PHARMD
Provider Business Mailing Address
First Line : 2302 AVENUE O APT D5
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-5102
Country : US
Telephone Number : 347-324-2907
Fax Number :
Provider Business Practice Location Address
First Line : 464 AVENUE U
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-4011
Country : US
Telephone Number : 718-676-6445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2016
Last Update Date : 08/25/2016

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