Provider Demographics
NPI:1205381704
Name:YEVDAYEVA, NADEZHDA (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:NADEZHDA
Middle Name:
Last Name:YEVDAYEVA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 AVENUE O APT D5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5102
Mailing Address - Country:US
Mailing Address - Phone:347-324-2907
Mailing Address - Fax:
Practice Address - Street 1:464 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-4011
Practice Address - Country:US
Practice Address - Phone:718-676-6445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061769-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist