Provider Demographics
NPI:1093045767
Name:UHM, THOMAS CHANG (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:CHANG
Last Name:UHM
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 1:1437 14TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-2006
Mailing Address - Country:US
Mailing Address - Phone:551-486-0343
Mailing Address - Fax:718-324-1818
Practice Address - Street 1:1437 14TH ST
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-2006
Practice Address - Country:US
Practice Address - Phone:551-486-0343
Practice Address - Fax:718-324-1818
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-02
Last Update Date:2010-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045897183500000X
NJ28RI02802400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02802400OtherNEW JERSEY BOARD OF PHARMACY
NY045897OtherNEW YORK STATE BOARD OF PHARMACY