Provider Demographics
NPI:1023342110
Name:NG, KENNY YAT (PHARMACIST)
Entity type:Individual
Prefix:
First Name:KENNY
Middle Name:YAT
Last Name:NG
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6275 TRANSIT RD.
Mailing Address - Street 2:WALGREENS PHARMACY
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051
Mailing Address - Country:US
Mailing Address - Phone:716-634-0956
Mailing Address - Fax:
Practice Address - Street 1:5275 TRANSIT RD.
Practice Address - Street 2:WALGREENS
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-639-8598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046151183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist