Healthcare Provider Details

I. General information

NPI: 1861012312
Provider Name (Legal Business Name): MEGAN J HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 04/24/2020
Certification Date: 04/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 PARK AVE STE 104
PLAINFIELD NJ
07080
US

IV. Provider business mailing address

111 CHESAPEAKE AVE
LAKE HIAWATHA NJ
07034-1715
US

V. Phone/Fax

Practice location:
  • Phone: 908-821-9888
  • Fax:
Mailing address:
  • Phone: 201-323-3075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04067200
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier28RI04067200
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerNJ DIVISION OF CONSUMER AFFAIRS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: