Provider Demographics
NPI:1073177234
Name:VAYNKHADLER, EDUARD (RPH)
Entity Type:Individual
Prefix:DR
First Name:EDUARD
Middle Name:
Last Name:VAYNKHADLER
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 1:2605 MILL AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6418
Mailing Address - Country:US
Mailing Address - Phone:917-254-8077
Mailing Address - Fax:
Practice Address - Street 1:2605 MILL AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6418
Practice Address - Country:US
Practice Address - Phone:917-254-8077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist