Provider Demographics
NPI:1295509024
Name:SYDORSKA, ANNA VIKTORIVNA (PHARMD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:VIKTORIVNA
Last Name:SYDORSKA
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 1:133 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-7008
Mailing Address - Country:US
Mailing Address - Phone:828-450-1756
Mailing Address - Fax:
Practice Address - Street 1:3681 BOILING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316-6021
Practice Address - Country:US
Practice Address - Phone:864-578-2414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC44142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist