Provider Demographics
NPI:1053592634
Name:SHEVELEVA, YULIYA (PHARM D)
Entity type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:SHEVELEVA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 80TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1610
Mailing Address - Country:US
Mailing Address - Phone:718-232-3147
Mailing Address - Fax:
Practice Address - Street 1:1417 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3319
Practice Address - Country:US
Practice Address - Phone:718-787-1665
Practice Address - Fax:718-787-1698
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist