Provider Demographics
NPI:1598044778
Name:YANG, MELISSA (PHARM D)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:YANG
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 1:17221 46TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3307
Mailing Address - Country:US
Mailing Address - Phone:718-358-4124
Mailing Address - Fax:718-358-4320
Practice Address - Street 1:17221 46TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3307
Practice Address - Country:US
Practice Address - Phone:718-358-4124
Practice Address - Fax:718-358-4320
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist