Provider Demographics
NPI:1174931489
Name:BORICHEVSKIY, LILIYA
Entity type:Individual
Prefix:DR
First Name:LILIYA
Middle Name:
Last Name:BORICHEVSKIY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8961 GREENBACK LN
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-4601
Mailing Address - Country:US
Mailing Address - Phone:916-873-4450
Mailing Address - Fax:
Practice Address - Street 1:8961 GREENBACK LN
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-4601
Practice Address - Country:US
Practice Address - Phone:916-989-9380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist