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General NPI Number Information
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NPI Number | 1659794931
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Entity Type | Individual
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Provider Name | LINDA WANG PHARM D
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Gender | Female
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Dates
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Enumeration Date | 01/22/2014
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Last Update Date | 01/22/2014
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Provider Practice Location Address
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Address Line | 1825 EASTCHESTER RD
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City | BRONX
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State | NY
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Zip | 10461-2301
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Country | US
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Telephone | 718-904-2838
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Fax |
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Provider Business Mailing Address
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Address Line | 14609 HAWTHORNE AVE # 2
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City | FLUSHING
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State | NY
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Zip | 11355-2239
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Country | US
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Telephone | 917-892-3372
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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 | 058723
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License Number State | NY
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