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General NPI Number Information
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NPI Number | 1720529761
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Entity Type | Individual
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Provider Name | AMY MIJIN CHA PHARM. D.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 55 PALMER AVE
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City | BRONXVILLE
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State | NY
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Zip | 10708-3403
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Country | US
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Telephone | 914-787-3336
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Fax |
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Provider Business Mailing Address
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Address Line | 6733 167TH ST
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-3207
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Country | US
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Telephone | 917-365-9850
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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 | 061106
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License Number State | NY
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