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General NPI Number Information
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NPI Number | 1962026922
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Entity Type | Individual
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Provider Name | WOOTACK KANG
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Gender | Male
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Dates
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Enumeration Date | 06/04/2020
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 164 PARSIPPANY RD
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City | PARSIPPANY
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State | NJ
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Zip | 07054-4708
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Country | US
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Telephone | 973-887-9444
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Fax |
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Provider Business Mailing Address
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Address Line | 70 RESERVOIR AVE APT 2B
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City | RIVER EDGE
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State | NJ
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Zip | 07661-2501
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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 | 28RI04092700
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License Number State | NJ
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