Provider Demographics
NPI:1912495789
Name:BEKBAYEVA, SAULE KABASHEVNA
Entity Type:Individual
Prefix:
First Name:SAULE
Middle Name:KABASHEVNA
Last Name:BEKBAYEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W 80TH ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-7047
Mailing Address - Country:US
Mailing Address - Phone:646-763-4812
Mailing Address - Fax:
Practice Address - Street 1:203 W 80TH ST APT 4A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-7047
Practice Address - Country:US
Practice Address - Phone:646-763-4812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist