Provider Demographics
NPI:1851578504
Name:YIU, JOAN S (RPH)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:S
Last Name:YIU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-0043
Mailing Address - Country:US
Mailing Address - Phone:516-490-5595
Mailing Address - Fax:516-490-5594
Practice Address - Street 1:336 N BROADWAY
Practice Address - Street 2:INSIDE HMART
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2031
Practice Address - Country:US
Practice Address - Phone:516-490-5595
Practice Address - Fax:516-490-5594
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist