Provider Demographics
NPI:1245735687
Name:MORGOVSKIY, ROMAN (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:
First Name:ROMAN
Middle Name:
Last Name:MORGOVSKIY
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2262 E 28TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5058
Mailing Address - Country:US
Mailing Address - Phone:347-254-6293
Mailing Address - Fax:
Practice Address - Street 1:2262 E 28TH ST FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5058
Practice Address - Country:US
Practice Address - Phone:347-254-6293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063731-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY063731-1OtherNATIONAL BOARD OF PHARMACY NABP