Healthcare Provider Details

I. General information

NPI: 1174770192
Provider Name (Legal Business Name): PATRICK YEE-CHAN R PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 08/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 LUDWIG LN
E WILLISTON NY
11596-1422
US

IV. Provider business mailing address

127 LUDWIG LN
E WILLISTON NY
11596-1422
US

V. Phone/Fax

Practice location:
  • Phone: 516-248-3922
  • Fax:
Mailing address:
  • Phone: 516-248-3922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number030039
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: