Susie Yang
Individual provider Active NPI Pharmacist · Staten Island, NY
NPI 1154895290 · NPPES record last updated Sep 28, 2023
Key facts
- NPI
- 1154895290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0014215 (CT)
- Practice address
- 2690 Hylan Blvd
Staten Island, NY 10306-4336 - Phone
- (718) 987-9727
- NPI assigned
- Jan 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0014215 | CT | MD | Pharmacist |
| 065038 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunning Pharmacy Inc. | Current |
Accepting new patients | |
| CVS Albany LLC | Past |
Accepting new patients | |
| Connecticut CVS Pharmacy LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past |
Accepting new patients | |
| Connecticut CVS Pharmacy, L.L.C. | Past | Accepting new patients |
Locations
1836 Hylan Blvd
Ste B
Staten Island, NY 10305
Phone (917) 565-8666
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 065038 | NY | |
| Pharmacist | 183500000X | 0014215 | CT | Yes |
Addresses
Primary practice location
2690 Hylan Blvd
Staten Island, NY 10306-4336
Mailing address
1836 Hylan Blvd Ste B
Staten Island, NY 10305-1935
Phone (917) 565-8666
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.