Provider Demographics
NPI:1023353158
Name:YIU, ALLAN W (BSC)
Entity type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:W
Last Name:YIU
Suffix:
Gender:M
Credentials:BSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-3606
Mailing Address - Country:US
Mailing Address - Phone:781-431-7522
Mailing Address - Fax:
Practice Address - Street 1:75 SPRING ST
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-4335
Practice Address - Country:US
Practice Address - Phone:617-327-9360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR3855183500000X
MAPH16976183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist