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General NPI Number Information
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NPI Number | 1407475213
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Entity Type | Individual
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Provider Name | JANE JANG PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/11/2020
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 1450 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4405
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Country | US
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Telephone | 203-789-4076
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Fax |
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Provider Business Mailing Address
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Address Line | 2 WASHINGTON AVE APT 521
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City | NEW HAVEN
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State | CT
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Zip | 06519-1653
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Country | US
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Telephone | 224-616-0582
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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 | 051302042
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0015476
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License Number State | CT
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