Provider Demographics
NPI:1427378496
Name:SHTEYN, RUSLANA
Entity Type:Individual
Prefix:
First Name:RUSLANA
Middle Name:
Last Name:SHTEYN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1467 ROYCE ST
Mailing Address - Street 2:APT 3K
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5923
Mailing Address - Country:US
Mailing Address - Phone:646-400-7945
Mailing Address - Fax:
Practice Address - Street 1:395 DANFORTH AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-1975
Practice Address - Country:US
Practice Address - Phone:201-200-9801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03297100183500000X
PARP443960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist