Active NPI
Wing K Fung
- Pharmacist
- Manchester, CT
National Provider Identifier
1164718342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5629
- Practice address
- 335 Center St
Manchester, CT 06040-3922 - Phone
- (860) 649-9110
- NPI assigned
- Jun 25, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5629 | CT | Primary |
Addresses
Primary practice location
335 Center St
Manchester, CT 06040-3922
Mailing address
2705 Mill Pond Dr
South Windsor, CT 06074-3560
Phone (860) 644-6824
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5629 | CT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308960000000",
"number": "1164718342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2705 MILL POND DR",
"city": "SOUTH WINDSOR",
"state": "CT",
"postal_code": "060743560",
"telephone_number": "860-644-6824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 CENTER ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060403922",
"telephone_number": "860-649-9110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNG",
"first_name": "WING",
"middle_name": "K",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-25",
"last_updated": "2011-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "5629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.