Provider Demographics
NPI:1770639023
Name:YI, ASA IN-SANG (RPH, PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ASA
Middle Name:IN-SANG
Last Name:YI
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 VIKING LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3334
Mailing Address - Country:US
Mailing Address - Phone:609-707-0815
Mailing Address - Fax:
Practice Address - Street 1:408 VIKING LN
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3334
Practice Address - Country:US
Practice Address - Phone:609-707-0815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03029000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist