Provider Demographics
NPI:1275003378
Name:POON, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:POON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35-19 LEAVITT ST.
Mailing Address - Street 2:#51
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:718-445-1888
Mailing Address - Fax:718-445-8887
Practice Address - Street 1:35-19 LEAVITT ST.
Practice Address - Street 2:#51
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:718-445-1888
Practice Address - Fax:718-445-8887
Is Sole Proprietor?:No
Enumeration Date:2018-11-30
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064959-I183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist