Provider Demographics
NPI:1790008076
Name:BOYADJIAN, NYEREE ANI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NYEREE
Middle Name:ANI
Last Name:BOYADJIAN
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 1:999 CORPORATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6614
Mailing Address - Country:US
Mailing Address - Phone:516-222-8841
Mailing Address - Fax:
Practice Address - Street 1:999 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6614
Practice Address - Country:US
Practice Address - Phone:516-222-8841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist