Provider Demographics
NPI:1588084412
Name:YAP, EIZEL
Entity type:Individual
Prefix:
First Name:EIZEL
Middle Name:
Last Name:YAP
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 1:3560 W PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4026
Mailing Address - Country:US
Mailing Address - Phone:602-938-3400
Mailing Address - Fax:602-547-1905
Practice Address - Street 1:3560 W PEORIA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4026
Practice Address - Country:US
Practice Address - Phone:602-938-3400
Practice Address - Fax:602-547-1905
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist