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General NPI Number Information
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NPI Number | 1194500405
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Entity Type | Individual
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Provider Name | MARSHALL YUAN
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Gender | Male
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 722 ROUTE 18
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3723
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Country | US
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Telephone | 732-257-3794
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MCGOVERN CT
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-2576
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI04313900
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License Number State | NJ
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