Healthcare Provider Details

I. General information

NPI: 1750797882
Provider Name (Legal Business Name): KHANG NGO PHARM.D., M.H.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MUNRO AVE
CAPE MAY NJ
08204-5000
US

IV. Provider business mailing address

1 MUNRO AVE
CAPE MAY NJ
08204-5000
US

V. Phone/Fax

Practice location:
  • Phone: 609-898-6863
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH55371
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: