Provider Demographics
NPI:1417105925
Name:SUVALSKY, MILENA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MILENA
Middle Name:
Last Name:SUVALSKY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 BEACH CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1415
Mailing Address - Country:US
Mailing Address - Phone:917-892-6752
Mailing Address - Fax:718-474-7777
Practice Address - Street 1:6608 BEACH CHANNEL DR
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1415
Practice Address - Country:US
Practice Address - Phone:917-892-6752
Practice Address - Fax:718-474-7777
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist