Provider Demographics
NPI:1427370717
Name:BYUN, ELLIE SUNGHEE (RPH)
Entity Type:Individual
Prefix:MS
First Name:ELLIE
Middle Name:SUNGHEE
Last Name:BYUN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:SUNGHEE
Other - Middle Name:
Other - Last Name:BYUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 WEYMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-1409
Mailing Address - Country:US
Mailing Address - Phone:914-235-7120
Mailing Address - Fax:914-235-6626
Practice Address - Street 1:16 WEYMAN AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-1409
Practice Address - Country:US
Practice Address - Phone:914-235-7120
Practice Address - Fax:914-235-6626
Is Sole Proprietor?:No
Enumeration Date:2010-02-27
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053188-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist