Provider Demographics
NPI:1093118283
Name:YANG, ANDREW C (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:C
Last Name:YANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 HALF HOLLOW RD
Mailing Address - Street 2:PHARMACY DEPT
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5859
Mailing Address - Country:US
Mailing Address - Phone:631-370-1669
Mailing Address - Fax:631-370-1671
Practice Address - Street 1:197 HALF HOLLOW RD
Practice Address - Street 2:PHARMACY DEPT
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5859
Practice Address - Country:US
Practice Address - Phone:631-370-1669
Practice Address - Fax:631-370-1671
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059470183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist