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General NPI Number Information
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NPI Number | 1417656679
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Entity Type | Individual
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Provider Name | LUCIA LI WANG PHARMD.
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Gender | Female
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 1111 AMSTERDAM AVE. CLARK/S&R BUILDING, 10TH FL. SUITE 8-1011
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City | NEW YORK
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State | NY
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Zip | 10025-1002
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Country | US
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Telephone | 212-523-9202
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Fax |
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Provider Business Mailing Address
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Address Line | 3960 54TH ST APT 7F
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City | WOODSIDE
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State | NY
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Zip | 11377-4216
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Country | US
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Telephone | 718-288-2046
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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 | 064396
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License Number State | NY
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