Provider Demographics
NPI:1891264610
Name:BUKINICH, VOLHA (DR)
Entity Type:Individual
Prefix:MRS
First Name:VOLHA
Middle Name:
Last Name:BUKINICH
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 OCEAN PKWY APT 20E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8251
Mailing Address - Country:US
Mailing Address - Phone:718-200-4153
Mailing Address - Fax:
Practice Address - Street 1:1242 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-7619
Practice Address - Country:US
Practice Address - Phone:718-941-2669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY064579OtherPHARMACIST LISENCE