Provider Demographics
NPI:1568617629
Name:MOGILEVICH, NINEL (BS PHARMACY)
Entity Type:Individual
Prefix:MRS
First Name:NINEL
Middle Name:
Last Name:MOGILEVICH
Suffix:
Gender:F
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8012 20TH AVE
Mailing Address - Street 2:BE WELL PHARMACY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1809
Mailing Address - Country:US
Mailing Address - Phone:718-232-2320
Mailing Address - Fax:
Practice Address - Street 1:8012 20TH AVE
Practice Address - Street 2:BE WELL PHARMACY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-1809
Practice Address - Country:US
Practice Address - Phone:718-232-2320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist