Healthcare Provider Details

I. General information

NPI: 1073118865
Provider Name (Legal Business Name): KIMBERLY YEE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 S RIDGE ST
RYE BROOK NY
10573-3414
US

IV. Provider business mailing address

19 BONAVENTURE AVE
ARDSLEY NY
10502-2103
US

V. Phone/Fax

Practice location:
  • Phone: 914-937-2220
  • Fax:
Mailing address:
  • Phone: 718-877-2868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number060909
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: