Provider Demographics
NPI:1053635417
Name:BARANOVSKAYA KHENKIN, YULIYA (RPH)
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:BARANOVSKAYA KHENKIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:KHENKIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:1401 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3319
Mailing Address - Country:US
Mailing Address - Phone:718-382-5500
Mailing Address - Fax:718-382-1195
Practice Address - Street 1:1401 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3319
Practice Address - Country:US
Practice Address - Phone:718-382-5500
Practice Address - Fax:718-382-1195
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist