Healthcare Provider Details

I. General information

NPI: 1134526379
Provider Name (Legal Business Name): YONGMU HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2014
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S CENTRAL AVE
LAUREL DE
19956-1418
US

IV. Provider business mailing address

23069 MEADOW WOOD CT UNIT 321
SEAFORD DE
19973-7745
US

V. Phone/Fax

Practice location:
  • Phone: 302-875-7844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0004666
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: