Provider Demographics
NPI:1720269343
Name:YUNUS, BENIAMIN (PHARM D)
Entity type:Individual
Prefix:MR
First Name:BENIAMIN
Middle Name:
Last Name:YUNUS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:987-989 ALLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-4127
Mailing Address - Country:US
Mailing Address - Phone:718-405-9111
Mailing Address - Fax:718-405-9112
Practice Address - Street 1:987-989 ALLLERTON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4127
Practice Address - Country:US
Practice Address - Phone:718-405-9111
Practice Address - Fax:718-405-9112
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03418224Medicaid
NY01776392Medicaid
NY03418224Medicaid