Healthcare Provider Details

I. General information

NPI: 1598050114
Provider Name (Legal Business Name): SON CHUNG YEE PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2011
Last Update Date: 06/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1434 S BLACK HORSE PIKE
WILLIAMSTOWN NJ
08094-9130
US

IV. Provider business mailing address

1434 S BLACK HORSE PIKE
WILLIAMSTOWN NJ
08094-9130
US

V. Phone/Fax

Practice location:
  • Phone: 856-740-9612
  • Fax: 856-740-9616
Mailing address:
  • Phone: 856-740-9612
  • Fax: 856-740-9616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03081000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: