Healthcare Provider Details

I. General information

NPI: 1609533991
Provider Name (Legal Business Name): BRIGITTE LEEYEN TSANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2021
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4112 MAIN ST
FLUSHING NY
11355-3133
US

IV. Provider business mailing address

4112 MAIN ST
FLUSHING NY
11355-3133
US

V. Phone/Fax

Practice location:
  • Phone: 718-886-7128
  • Fax:
Mailing address:
  • Phone: 718-886-7128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number068542
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: