Provider Demographics
NPI:1477803765
Name:YUDCHYTS, HANNA
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:YUDCHYTS
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 1:620 W 42ND ST
Mailing Address - Street 2:APT 33A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-2014
Mailing Address - Country:US
Mailing Address - Phone:347-403-0368
Mailing Address - Fax:
Practice Address - Street 1:619 9TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-3710
Practice Address - Country:US
Practice Address - Phone:212-581-0602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist