Healthcare Provider Details

I. General information

NPI: 1467783555
Provider Name (Legal Business Name): JANICE JING YAO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2010
Last Update Date: 01/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3809 MAIN ST
FLUSHING NY
11354-5517
US

IV. Provider business mailing address

3809 MAIN ST
FLUSHING NY
11354-5517
US

V. Phone/Fax

Practice location:
  • Phone: 917-886-3038
  • Fax:
Mailing address:
  • Phone: 917-886-3038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number044697
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: