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NPI Code Detail

MEDICARE: VICTORIA A DEZORAIEV PHARMD

MEDICARE:   VICTORIA A DEZORAIEV  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
1183500000XPharmacist058186NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1058186OTHERNYSTATE BOARD

General Provider Information

NPI Number : 1285353300
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA A DEZORAIEV PHARMD
Provider Business Mailing Address
First Line : 861 MIDLAND AVE
Second Line :
City : YONKERS
State : NY
Zip : 10704-1024
Country : US
Telephone Number : 718-908-1762
Fax Number :
Provider Business Practice Location Address
First Line : 861 MIDLAND AVE
Second Line :
City : YONKERS
State : NY
Zip : 10704-1024
Country : US
Telephone Number : 914-968-0349
Fax Number : 914-968-0357
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2022
Last Update Date : 08/23/2022

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Directions to “ VICTORIA A DEZORAIEV PHARMD” Practice Location

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