Provider Demographics
NPI:1689980369
Name:YANG, ALICE JUNG-HEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:JUNG-HEE
Last Name:YANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 PORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-2212
Mailing Address - Country:US
Mailing Address - Phone:650-833-9164
Mailing Address - Fax:410-374-8262
Practice Address - Street 1:714 PORTLAND ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-2212
Practice Address - Country:US
Practice Address - Phone:650-833-9164
Practice Address - Fax:410-374-8262
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD170561835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist