Provider Demographics
NPI:1386967214
Name:BERSHADSKY, MIKHAIL (PHARM D)
Entity type:Individual
Prefix:
First Name:MIKHAIL
Middle Name:
Last Name:BERSHADSKY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:BERSHADSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2940 OCEAN PKWY
Mailing Address - Street 2:APT 19K
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:126 8TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5108
Practice Address - Country:US
Practice Address - Phone:212-807-8798
Practice Address - Fax:212-645-1429
Is Sole Proprietor?:No
Enumeration Date:2010-03-06
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054381183500000X
NY20 054381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist