Provider Demographics
NPI:1578841565
Name:VINSHTOK, LYUDMILA (R,PH)
Entity type:Individual
Prefix:MS
First Name:LYUDMILA
Middle Name:
Last Name:VINSHTOK
Suffix:
Gender:F
Credentials:R,PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 AVENUE P
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1009
Mailing Address - Country:US
Mailing Address - Phone:718-902-8515
Mailing Address - Fax:
Practice Address - Street 1:1220 AVENUE P
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1009
Practice Address - Country:US
Practice Address - Phone:718-902-8515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046077183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist