Provider Demographics
NPI:1982957676
Name:SHAYKEVICH, YURIY (RPH)
Entity type:Individual
Prefix:DR
First Name:YURIY
Middle Name:
Last Name:SHAYKEVICH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 STERN CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-2164
Mailing Address - Country:US
Mailing Address - Phone:718-702-4949
Mailing Address - Fax:
Practice Address - Street 1:94 NASSAU AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-3203
Practice Address - Country:US
Practice Address - Phone:718-702-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist