Provider Demographics
NPI:1699159731
Name:LENCHITSKY, VLADIMIR
Entity type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:LENCHITSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7039 VALJEAN AVE.
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91403
Mailing Address - Country:US
Mailing Address - Phone:818-390-9696
Mailing Address - Fax:818-390-9697
Practice Address - Street 1:7039 VALJEAN AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3915
Practice Address - Country:US
Practice Address - Phone:818-390-9696
Practice Address - Fax:818-390-9697
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist