Provider Demographics
NPI:1407294762
Name:HE, JIA YING (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JIA
Middle Name:YING
Last Name:HE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11020-1609
Mailing Address - Country:US
Mailing Address - Phone:917-886-8263
Mailing Address - Fax:
Practice Address - Street 1:1 LAKE RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11020-1609
Practice Address - Country:US
Practice Address - Phone:917-886-8263
Practice Address - Fax:718-632-8297
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist