Healthcare Provider Details

I. General information

NPI: 1194236489
Provider Name (Legal Business Name): ELAINE YAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2017
Last Update Date: 10/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3657 MAIN ST
FLUSHING NY
11354-4104
US

IV. Provider business mailing address

4040 75TH ST APT 4E
ELMHURST NY
11373-1049
US

V. Phone/Fax

Practice location:
  • Phone: 718-961-8001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number063597
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: