Provider Demographics
NPI:1295200723
Name:KLIMENKO, YULIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:YULIA
Middle Name:
Last Name:KLIMENKO
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 1:5 HORIZON RD APT 905
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6634
Mailing Address - Country:US
Mailing Address - Phone:718-310-9497
Mailing Address - Fax:
Practice Address - Street 1:1301 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-1504
Practice Address - Country:US
Practice Address - Phone:347-918-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064510183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist