Provider Demographics
NPI:1396782157
Name:NG, SHIU-LUN GARY (RPH)
Entity type:Individual
Prefix:MR
First Name:SHIU-LUN
Middle Name:GARY
Last Name:NG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 N ITHAN AVE
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1652
Mailing Address - Country:US
Mailing Address - Phone:215-627-4567
Mailing Address - Fax:
Practice Address - Street 1:222 N 9TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1822
Practice Address - Country:US
Practice Address - Phone:215-627-4567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030758L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP030758LOtherPHARMACIST LIC #