Provider Demographics
NPI:1194158857
Name:SANCHUK, SVYATOSLAV (PHARM D)
Entity type:Individual
Prefix:
First Name:SVYATOSLAV
Middle Name:
Last Name:SANCHUK
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 1:2232 BRIGHAM ST
Mailing Address - Street 2:APT# 4L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-6141
Mailing Address - Country:US
Mailing Address - Phone:347-922-1788
Mailing Address - Fax:
Practice Address - Street 1:2232 BRIGHAM ST
Practice Address - Street 2:APT# 4L
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-6141
Practice Address - Country:US
Practice Address - Phone:347-922-1788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058442183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist