MEDICARE: DR. TINA CHANG-YIP PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	059186	NY

General Provider Information

NPI Number	:	1548676323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA CHANG-YIP PHARMD

Provider Business Mailing Address
First Line	:	65 TIBBETTS RD
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10705-4625
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 E SANDFORD BLVD
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-4623
Country	:	US
Telephone Number	:	914-664-9250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2014
Last Update Date	:	07/01/2014

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