MEDICARE: HYUN TANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP441081	PA

General Provider Information

NPI Number	:	1063056653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYUN TANG

Provider Business Mailing Address
First Line	:	5600 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-2306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5600 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-2306
Country	:	US
Telephone Number	:	215-224-3333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2019
Last Update Date	:	11/06/2019

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Directions to “ HYUN TANG ” Practice Location

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