Victoria A Dezoraiev, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

058186 Issued in NY

Practice address

861 Midland Ave
Yonkers, NY 10704-1024

Phone

(914) 968-0349

Fax

(914) 968-0357

NPI assigned

Aug 23, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midland Pharmacy Yonkers Corp.

  • Community/Retail Pharmacy
  • Yonkers, NY
  • NPI 1578290433
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1285353300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 MIDLAND AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107041024",
            "telephone_number": "718-908-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 MIDLAND AVE",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107041024",
            "telephone_number": "914-968-0349",
            "fax_number": "914-968-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZORAIEV",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "058186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD",
            "identifier": "058186",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Tatiana Michi Devens
• Alana R. Devivo, LCSW
• Nancy Nicole Devivo, CASAC-T
• Colleen Devlin, RN
• Jessie Dewanjee, M.D.
• Manjeet Singh Dhallu, M.D.
• Tina Dhanai, LCSW
• Dhansukh Patel MD PC
• Isabel N Dharmaraj, D.D.S
• Yarl Nila Dhayaparan, D.O.

• Pharmacist in Yonkers, NY
• Providers in Yonkers, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.