Provider Demographics
NPI:1508131103
Name:VOLOSHCHUK, YEVGENIY (ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:YEVGENIY
Middle Name:
Last Name:VOLOSHCHUK
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 COYLE ST APT 321
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1734
Mailing Address - Country:US
Mailing Address - Phone:917-658-0152
Mailing Address - Fax:
Practice Address - Street 1:75 SMITH ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4413
Practice Address - Country:US
Practice Address - Phone:732-442-5542
Practice Address - Fax:732-442-5568
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00087900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist