Provider Demographics
NPI:1073921698
Name:YAN, QIONG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:QIONG
Middle Name:
Last Name:YAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:YAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1275 YORK AVE
Mailing Address - Street 2:SCHWARTZ 710
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:212-693-5235
Mailing Address - Fax:212-639-2171
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:SCHWARTZ 710
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:212-639-5235
Practice Address - Fax:212-639-2171
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA683761835P0018X
NY0585151835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist