Provider Demographics
NPI:1598038085
Name:YANNI, NIVEEN
Entity Type:Individual
Prefix:
First Name:NIVEEN
Middle Name:
Last Name:YANNI
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 1:883 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1704
Mailing Address - Country:US
Mailing Address - Phone:212-245-8469
Mailing Address - Fax:212-586-1502
Practice Address - Street 1:883 9TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1704
Practice Address - Country:US
Practice Address - Phone:212-245-8469
Practice Address - Fax:212-586-1502
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist