Provider Demographics
NPI:1952585002
Name:BUBIS, YEFIM (RPH)
Entity Type:Individual
Prefix:MR
First Name:YEFIM
Middle Name:
Last Name:BUBIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3706
Mailing Address - Country:US
Mailing Address - Phone:718-314-8002
Mailing Address - Fax:718-941-2300
Practice Address - Street 1:1810 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3706
Practice Address - Country:US
Practice Address - Phone:718-314-8002
Practice Address - Fax:718-941-2300
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050017-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist