Provider Demographics
NPI:1760652432
Name:GRACHEVA, RADMILA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:RADMILA
Middle Name:
Last Name:GRACHEVA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 AVE OF THE AMERICAS
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2056
Mailing Address - Country:US
Mailing Address - Phone:212-691-0952
Mailing Address - Fax:
Practice Address - Street 1:611 AVE OF THE AMERICAS
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2056
Practice Address - Country:US
Practice Address - Phone:212-691-0952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-09
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist