Healthcare Provider Details

I. General information

NPI: 1144994641
Provider Name (Legal Business Name): XUANQING WANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 MURRAY AVE
PITTSBURGH PA
15217-1604
US

IV. Provider business mailing address

5700 CENTRE AVE APT 707
PITTSBURGH PA
15206-3738
US

V. Phone/Fax

Practice location:
  • Phone: 412-521-3900
  • Fax:
Mailing address:
  • Phone: 315-447-8003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP455908
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: