Provider Demographics
NPI:1871771386
Name:LEVIYEVA, INEL (RPH)
Entity type:Individual
Prefix:
First Name:INEL
Middle Name:
Last Name:LEVIYEVA
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 1:2806 EAST 23 RD ST
Mailing Address - Street 2:APT # 1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:718-687-6922
Mailing Address - Fax:718-332-2971
Practice Address - Street 1:2806 E 23RD ST
Practice Address - Street 2:APT # 1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2786
Practice Address - Country:US
Practice Address - Phone:718-687-6922
Practice Address - Fax:718-332-2971
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047424183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist