MEDICARE: IRYNA MAKUKH 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	RPI010893	PA

General Provider Information

NPI Number	:	1831851666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRYNA MAKUKH PHARMD

Provider Business Mailing Address
First Line	:	948 SHERMAN AVE
Second Line	:
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-8738
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7601 CASTOR AVE STE 2
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-4026
Country	:	US
Telephone Number	:	215-722-2500
Fax Number	:

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

Provider Enumeration Date	:	10/08/2021
Last Update Date	:	10/08/2021

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