Individual
DR. ANNA KOSTYUCHENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E 77 ST, NEW YORK, NY 10075
(212) 434-3226
Mailing address
3172 CONEY ISLAND AVE # 620, BROOKLYN, NY 11235-6411
(212) 434-3226
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
056828
NY
Other
Enumeration date
07/13/2012
Last updated
08/03/2015
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