Provider Demographics
NPI:1497077556
Name:MLYNARYK, EVA I (RPH)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:I
Last Name:MLYNARYK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:I
Other - Last Name:JAREMCZUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:205 E 63RD ST # AT
Mailing Address - Street 2:APT 10D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 E 63RD ST
Practice Address - Street 2:APT 10D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7425
Practice Address - Country:US
Practice Address - Phone:212-319-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038161-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist