Provider Demographics
NPI:1609108463
Name:SHLAFMAN, VITALINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VITALINA
Middle Name:
Last Name:SHLAFMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:773 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-6013
Mailing Address - Country:US
Mailing Address - Phone:718-979-8279
Mailing Address - Fax:
Practice Address - Street 1:2456 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5804
Practice Address - Country:US
Practice Address - Phone:718-697-0422
Practice Address - Fax:718-697-0427
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist