Provider Demographics
NPI:1689962268
Name:YOO, GRACE K (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:K
Last Name:YOO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GLEN RD
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-1403
Mailing Address - Country:US
Mailing Address - Phone:914-693-1527
Mailing Address - Fax:
Practice Address - Street 1:7 GLEN RD
Practice Address - Street 2:
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1403
Practice Address - Country:US
Practice Address - Phone:914-693-1527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032561-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist