Individual provider · NPI-1

Yong Tae Chang, rph

Pharmacist · Mount Vernon, NY

NPI number1730350455
StatusActive
Last updated in NPPESFeb 27, 2012

Details

NPI
1730350455
Entity type
Individual (NPI-1)
Name
Yong Tae Chang
Credential
rph
Sex
Male
Sole proprietor
No
Enumeration date
Mar 20, 2008
Last updated
Feb 27, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist039818NYYes

Practice location

1 Pathmark Plz
Mount Vernon, NY 10550-3518

Phone 914-668-5989 · Fax 914-668-6005

Mailing address

1 Pathmark Plz
Mount Vernon, NY 10550-3518

Phone 914-668-5989 · Fax 914-668-6005

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