Provider Demographics
NPI:1992955579
Name:HON, AMANDA YAN (PHARMACIST)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:YAN
Last Name:HON
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 59TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3936
Mailing Address - Country:US
Mailing Address - Phone:718-567-3318
Mailing Address - Fax:718-567-3313
Practice Address - Street 1:762 59TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3936
Practice Address - Country:US
Practice Address - Phone:718-567-3318
Practice Address - Fax:718-567-3313
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047084-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist