Provider Demographics
NPI:1699109777
Name:MASHEYEV, YELENA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:YELENA
Middle Name:
Last Name:MASHEYEV
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9945 65TH RD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3654
Mailing Address - Country:US
Mailing Address - Phone:347-712-9175
Mailing Address - Fax:
Practice Address - Street 1:9945 65TH RD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3654
Practice Address - Country:US
Practice Address - Phone:347-712-9175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist