=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811170657
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHUI HANG HONG RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2007
-----------------------------------------------------
Last Update Date | 12/16/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 196 3RD AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10003-2503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-598-0339
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8431 55TH RD
-----------------------------------------------------
City | ELMHURST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11373-4815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-683-7400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 051484
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------