Provider Demographics
NPI:1710201595
Name:CHAO, AMY C (RPH)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:CHAO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CHING-KUEI
Other - Middle Name:A
Other - Last Name:CHAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:950 SOUTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-3402
Mailing Address - Country:US
Mailing Address - Phone:718-991-1376
Mailing Address - Fax:718-842-3600
Practice Address - Street 1:950 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459
Practice Address - Country:US
Practice Address - Phone:718-991-1376
Practice Address - Fax:718-842-3600
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050076-1183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist