Stephanie Chang
Individual provider Active NPI Pharmacist · Williston Park, NY
NPI 1104131036 · NPPES record last updated Aug 16, 2010
Key facts
- NPI
- 1104131036
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 049960 (NY)
- Practice address
- 88 Cornwell Ave
Williston Park, NY 11596-1534 - Phone
- (718) 670-1040
- NPI assigned
- Aug 16, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049960 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 049960 | NY | Yes |
Addresses
Primary practice location
88 Cornwell Ave
Williston Park, NY 11596-1534
Mailing address
88 Cornwell Ave
Williston Park, NY 11596-1534
Phone (718) 670-1040
Other providers in Williston Park, NY
- Kimberly Castro
- Ashley Nicole Catapano
- Priscila Cha
- Jeswin Chacko
- Lena Chan
- Nirveeta Devika Charles
- Paul Chavez
- Wenjuan Chen
- Jayne Louise Chierico
- Sunmi Choe
All providers in Williston Park, NY · Pharmacist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.