Kinara Sara Yang
Individual provider Active NPI Pharmacist · Avon, MA
NPI 1295028215 · NPPES record last updated Sep 12, 2012
Key facts
- NPI
- 1295028215
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH232802 (MA)
- Practice address
- 120 Stockwell Dr
Costco Avon
Avon, MA 02322-1149 - Phone
- (508) 232-4003
- NPI assigned
- May 24, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| PH232802 | MA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH232802 | MA | Yes |
Addresses
Primary practice location
120 Stockwell Dr
Costco Avon
Avon, MA 02322-1149
Mailing address
120 Stockwell Dr
Costco Avon
Avon, MA 02322-1149
Phone (508) 232-4003
Other providers in Avon, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2012. 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.