MEDICARE: DAE HAN YOO PHARMD

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	064606	NY

General Provider Information

NPI Number	:	1841772241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAE HAN YOO PHARMD

Provider Business Mailing Address
First Line	:	6700 192ND ST APT 600
Second Line	:
City	:	FRESH MEADOWS
State	:	NY
Zip	:	11365-3779
Country	:	US
Telephone Number	:	516-732-6812
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-2034
Country	:	US
Telephone Number	:	718-827-9034
Fax Number	:

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

Provider Enumeration Date	:	08/31/2018
Last Update Date	:	02/09/2019

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Directions to “ DAE HAN YOO PHARMD” Practice Location

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