1407185978 NPI number — MRS. ALLA ABIGAIL ALAYEVA PHARM-D

Table of content: MRS. ALLA ABIGAIL ALAYEVA PHARM-D (NPI 1407185978)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407185978 NPI number — MRS. ALLA ABIGAIL ALAYEVA PHARM-D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALAYEVA
Provider First Name:
ALLA
Provider Middle Name:
ABIGAIL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARM-D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407185978
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/29/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14429 JEWEL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11367-1722
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-202-3464
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20011 HOLLIS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT ALBANS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11412-1711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-217-8230
Provider Business Practice Location Address Fax Number:
718-217-8472
Provider Enumeration Date:
12/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  050664 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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