Provider Demographics
NPI:1457670192
Name:PLYUSHKINA, YELENA (PHARMD)
Entity Type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:PLYUSHKINA
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 1:1846 ENGLISH CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4215
Mailing Address - Country:US
Mailing Address - Phone:215-880-7487
Mailing Address - Fax:
Practice Address - Street 1:1201 VOLVO PKWY
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-7654
Practice Address - Country:US
Practice Address - Phone:757-436-9157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202209596183500000X
PARP444165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist