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NPI Code Detail

MEDICARE: JANE TSYBULSKAYA

MEDICARE: JANE TSYBULSKAYA
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
1183500000XPharmacist051861NY

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 : 1376736322
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE TSYBULSKAYA
Provider Business Mailing Address
First Line : 2201 BATH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-5603
Country : US
Telephone Number : 718-372-0797
Fax Number : 718-372-0797
Provider Business Practice Location Address
First Line : 2201 BATH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-5603
Country : US
Telephone Number : 718-372-0797
Fax Number : 718-372-0797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2007
Last Update Date : 08/23/2007

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Directions to “ JANE TSYBULSKAYA ” Practice Location

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