Healthcare Provider Details

I. General information

NPI: 1952076572
Provider Name (Legal Business Name): JUDY HUANG PHD, PHARMD, BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 MAPLE ST
NORWALK CT
06850-3815
US

IV. Provider business mailing address

58 SEMINARY ST
NEW CANAAN CT
06840-4501
US

V. Phone/Fax

Practice location:
  • Phone: 203-852-3239
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPCT.0012995
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: