MEDICARE: THERESA K YEUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	048887	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396926218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA K YEUNG

Provider Business Mailing Address
First Line	:	16529 UNION TPKE
Second Line	:	1 FL
City	:	FLUSHING
State	:	NY
Zip	:	11366-1238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9602 ROCKAWAY BLVD
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11417-1613
Country	:	US
Telephone Number	:	718-848-2334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	11/19/2007

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Directions to “ THERESA K YEUNG ” Practice Location

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