Provider Demographics
NPI:1053474619
Name:WANG, FEI (MSC, PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:FEI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MSC, PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 STONE HILL DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-4258
Mailing Address - Country:US
Mailing Address - Phone:860-571-0465
Mailing Address - Fax:
Practice Address - Street 1:79 RETREAT AVE
Practice Address - Street 2:ADULT PRIMARY CARE PRACTICE
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2527
Practice Address - Country:US
Practice Address - Phone:860-545-4125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT88791835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy