Provider Demographics
NPI:1356063895
Name:RAZAKOV, ULUGBEK (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ULUGBEK
Middle Name:
Last Name:RAZAKOV
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11035 63RD AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1405
Mailing Address - Country:US
Mailing Address - Phone:347-216-7175
Mailing Address - Fax:
Practice Address - Street 1:9710 63RD RD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1639
Practice Address - Country:US
Practice Address - Phone:347-216-7175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist