Healthcare Provider Details

I. General information

NPI: 1942901731
Provider Name (Legal Business Name): MICHELE YEUNG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 BOWERY
NEW YORK NY
10002-4915
US

IV. Provider business mailing address

160 CANAL ST
NEW YORK NY
10013-4501
US

V. Phone/Fax

Practice location:
  • Phone: 212-571-0027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number063237
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: