Healthcare Provider Details
I. General information
NPI: 1306151899
Provider Name (Legal Business Name): XIAO JUN HUANG PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/10/2010
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
29 WEST 116TH ST
NEW YORK NY
10026
US
IV. Provider business mailing address
29 WEST 116 STREET
NEW YORK NY
10026
US
V. Phone/Fax
- Phone: 212-519-8346
- Fax: 212-519-8348
- Phone: 212-519-8346
- Fax: 212-519-8348
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 054953 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: