Provider Demographics
NPI:1083986913
Name:DZIAMIOKHINA, VALERIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:
Last Name:DZIAMIOKHINA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:DEMEKHIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2677 COLBY CT APT 5K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6127
Mailing Address - Country:US
Mailing Address - Phone:347-404-2137
Mailing Address - Fax:
Practice Address - Street 1:2677 COLBY CT APT 5K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6127
Practice Address - Country:US
Practice Address - Phone:347-404-2137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist