Healthcare Provider Details

I. General information

NPI: 1417134115
Provider Name (Legal Business Name): CHING-JEN HSU RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2709 CHILI AVE
ROCHESTER NY
14624-4123
US

IV. Provider business mailing address

170 CASTLEMAN RD
ROCHESTER NY
14620-4427
US

V. Phone/Fax

Practice location:
  • Phone: 585-426-2991
  • Fax: 585-247-0826
Mailing address:
  • Phone: 585-426-2991
  • Fax: 585-247-0826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number037147
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: