Provider Demographics
NPI:1588847404
Name:MICHALSKI, YVONNE MARIE
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:MARIE
Last Name:MICHALSKI
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 1:8 APPALOOSA TRL
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-4367
Mailing Address - Country:US
Mailing Address - Phone:631-471-7618
Mailing Address - Fax:
Practice Address - Street 1:17 COLLEGE PLZ
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-4034
Practice Address - Country:US
Practice Address - Phone:631-698-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist