Provider Demographics
NPI:1891977674
Name:LUM, CHIN YEE
Entity Type:Individual
Prefix:
First Name:CHIN YEE
Middle Name:
Last Name:LUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6654 FRESH POND RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11385-3245
Mailing Address - Country:US
Mailing Address - Phone:718-821-2222
Mailing Address - Fax:
Practice Address - Street 1:6654 FRESH POND RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11385-3245
Practice Address - Country:US
Practice Address - Phone:718-821-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist