Healthcare Provider Details

I. General information

NPI: 1619145216
Provider Name (Legal Business Name): GLENN H YEE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 ROCKLAND CTR
NANUET NY
10954-2956
US

IV. Provider business mailing address

142 GATTO LN
PEARL RIVER NY
10965-1003
US

V. Phone/Fax

Practice location:
  • Phone: 845-623-6220
  • Fax:
Mailing address:
  • Phone: 845-735-5272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number027324
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: