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NPI Code Detail

MEDICARE: SUSAN CHANG

MEDICARE: SUSAN CHANG
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
1183500000XPharmacistRP041670LPA

General Provider Information

NPI Number : 1780103028
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN CHANG
Provider Business Mailing Address
First Line : 1620 CHADWYCK PL
Second Line :
City : BLUE BELL
State : PA
Zip : 19422-2912
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2600 N AMERICAN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19133-3413
Country : US
Telephone Number : 215-426-1007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2017
Last Update Date : 09/19/2017

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Directions to “ SUSAN CHANG ” Practice Location

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