Provider Demographics
NPI:1871774307
Name:ZAVULUNOV, LEV (RPH)
Entity type:Individual
Prefix:MR
First Name:LEV
Middle Name:
Last Name:ZAVULUNOV
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 NASSAU ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-3455
Mailing Address - Country:US
Mailing Address - Phone:212-962-4900
Mailing Address - Fax:212-962-4910
Practice Address - Street 1:9 S MIDDLE NECK RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3455
Practice Address - Country:US
Practice Address - Phone:516-829-5900
Practice Address - Fax:516-829-5901
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist