Healthcare Provider Details

I. General information

NPI: 1851600381
Provider Name (Legal Business Name): RYUNGJA YEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2010
Last Update Date: 10/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1138
US

IV. Provider business mailing address

93 VALIMAR COURT
WHITE PLAINS NY
10603-1549
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-4560
  • Fax:
Mailing address:
  • Phone: 914-683-1134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number029548
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: