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General NPI Number Information
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NPI Number | 1629889167
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Entity Type | Individual
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Provider Name | ELLEN YI PHARMD, RPH, MBA
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Gender | Female
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 3A BOND ST
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City | GREAT NECK
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State | NY
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Zip | 11021-2408
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Country | US
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Telephone | 516-304-5893
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Fax |
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Provider Business Mailing Address
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Address Line | 3717 UNION ST FL 3
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City | FLUSHING
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State | NY
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Zip | 11354-4159
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Country | US
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Telephone | 646-420-1539
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 072425
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License Number State | NY
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