Provider Demographics
NPI:1023726643
Name:MISHIYEVA, OKSANA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:OKSANA
Middle Name:
Last Name:MISHIYEVA
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 1:360 OCEAN PKWY APT 2D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4642
Mailing Address - Country:US
Mailing Address - Phone:646-409-9324
Mailing Address - Fax:
Practice Address - Street 1:249 7TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3610
Practice Address - Country:US
Practice Address - Phone:646-409-9324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist