Provider Demographics
NPI:1093020737
Name:HU, SAMUEL FUNG-YUEN
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:FUNG-YUEN
Last Name:HU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ROUTE 37 E
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5375
Mailing Address - Country:US
Mailing Address - Phone:732-341-0022
Mailing Address - Fax:732-341-6877
Practice Address - Street 1:2 ROUTE 37 E
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5375
Practice Address - Country:US
Practice Address - Phone:732-341-0022
Practice Address - Fax:732-341-6877
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R102549300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist