Provider Demographics
NPI:1992978704
Name:CHANG, WEN CHI (PHARM D)
Entity type:Individual
Prefix:DR
First Name:WEN CHI
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13249 41ST RD
Mailing Address - Street 2:APT# 2A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4286
Mailing Address - Country:US
Mailing Address - Phone:917-880-7316
Mailing Address - Fax:
Practice Address - Street 1:1082 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2802
Practice Address - Country:US
Practice Address - Phone:212-223-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-12
Last Update Date:2008-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist