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NPI Code Detail

MEDICARE: MRS. SHOSHANA GADAEV

MEDICARE:  MRS. SHOSHANA  GADAEV
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
1183500000XPharmacist053211NY

General Provider Information

NPI Number : 1609190537
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHOSHANA GADAEV
Provider Business Mailing Address
First Line : 1215 AVENUE M
Second Line : APT 4G
City : BROOKLYN
State : NY
Zip : 11230-5245
Country : US
Telephone Number : 646-637-5696
Fax Number :
Provider Business Practice Location Address
First Line : 1215 AVENUE M
Second Line : APT 4G
City : BROOKLYN
State : NY
Zip : 11230-5245
Country : US
Telephone Number : 646-637-5696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2010
Last Update Date : 03/22/2010

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Directions to “ MRS. SHOSHANA GADAEV ” Practice Location

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