Provider Demographics
NPI:1043491632
Name:LAKHMAN, YELENA (RPH)
Entity type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:LAKHMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:10928-2103
Mailing Address - Country:US
Mailing Address - Phone:845-446-3170
Mailing Address - Fax:
Practice Address - Street 1:188 MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND FALLS
Practice Address - State:NY
Practice Address - Zip Code:10928-2103
Practice Address - Country:US
Practice Address - Phone:845-446-3170
Practice Address - Fax:845-446-2785
Is Sole Proprietor?:No
Enumeration Date:2007-11-24
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02003414Medicaid