MEDICARE: DR. LEORA MEJICOVSKY RUB 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
1	183500000X	Pharmacist	043446	NY

General Provider Information

NPI Number	:	1477875847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEORA MEJICOVSKY RUB PHARMD

Provider Business Mailing Address
First Line	:	41 JEFFERSON RD
Second Line	:
City	:	SCARSDALE
State	:	NY
Zip	:	10583-6437
Country	:	US
Telephone Number	:	914-472-0909
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 JEFFERSON RD
Second Line	:
City	:	SCARSDALE
State	:	NY
Zip	:	10583-6437
Country	:	US
Telephone Number	:	914-472-0909
Fax Number	:

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

Provider Enumeration Date	:	02/25/2010
Last Update Date	:	02/25/2010

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