Provider Demographics
NPI:1891046629
Name:VALUYEVA, YEKATERINA (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:YEKATERINA
Middle Name:
Last Name:VALUYEVA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:VALUYEVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2750 HOMECREST AVE
Mailing Address - Street 2:APT 325
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:917-543-0692
Mailing Address - Fax:
Practice Address - Street 1:2750 HOMECREST AVE
Practice Address - Street 2:APT 325
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4656
Practice Address - Country:US
Practice Address - Phone:917-543-0692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist