Provider Demographics
NPI:1730394032
Name:SHVYDKAYA, SVETLANA (PHARMD)
Entity type:Individual
Prefix:MS
First Name:SVETLANA
Middle Name:
Last Name:SHVYDKAYA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:SVETLANA
Other - Middle Name:
Other - Last Name:BRONFMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2485 EAST 3RD STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223
Mailing Address - Country:US
Mailing Address - Phone:917-609-8552
Mailing Address - Fax:
Practice Address - Street 1:1082 2ND AVE
Practice Address - Street 2:DUANE READE PHARMACY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2802
Practice Address - Country:US
Practice Address - Phone:212-223-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050244183500000X
NJ28RI02921700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist