Healthcare Provider Details

I. General information

NPI: 1093319675
Provider Name (Legal Business Name): RITCHEY YEUNG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2020
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 FRANKLIN TPKE
MAHWAH NJ
07430-1344
US

IV. Provider business mailing address

60 S FARVIEW AVE
PARAMUS NJ
07652-2630
US

V. Phone/Fax

Practice location:
  • Phone: 201-529-5930
  • Fax:
Mailing address:
  • Phone: 551-689-7726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04128600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: