Healthcare Provider Details

I. General information

NPI: 1992983266
Provider Name (Legal Business Name): LINDA JENNIFER YEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 ATLANTIC AVE
BROOKLYN NY
11217-1914
US

IV. Provider business mailing address

34 BAY RIDGE AVE APT 2B
BROOKLYN NY
11220-5072
US

V. Phone/Fax

Practice location:
  • Phone: 917-971-8787
  • Fax:
Mailing address:
  • Phone: 917-971-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number048088
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35603
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: