Provider Demographics
NPI:1477875847
Name:RUB, LEORA MEJICOVSKY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEORA
Middle Name:MEJICOVSKY
Last Name:RUB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LEORA
Other - Middle Name:
Other - Last Name:MEJICOVSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:41 JEFFERSON RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6437
Mailing Address - Country:US
Mailing Address - Phone:914-472-0909
Mailing Address - Fax:
Practice Address - Street 1:41 JEFFERSON RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6437
Practice Address - Country:US
Practice Address - Phone:914-472-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist