Healthcare Provider Details

I. General information

NPI: 1568590917
Provider Name (Legal Business Name): ELAINE Y HUNG R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BOWERY
NEW YORK NY
10002-6702
US

IV. Provider business mailing address

161 FERNDALE RD
SCARSDALE NY
10583-1926
US

V. Phone/Fax

Practice location:
  • Phone: 212-966-4420
  • Fax:
Mailing address:
  • Phone: 914-722-1618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number038972
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: