Provider Demographics
NPI:1073168225
Name:YUAN, TONY H (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:H
Last Name:YUAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 SAYREVILLE BLVD S
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-2143
Mailing Address - Country:US
Mailing Address - Phone:201-966-0657
Mailing Address - Fax:
Practice Address - Street 1:205 VINEYARD RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-4785
Practice Address - Country:US
Practice Address - Phone:732-491-2022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04031300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist