Provider Demographics
NPI:1336323187
Name:JAW, MING
Entity Type:Individual
Prefix:MS
First Name:MING
Middle Name:
Last Name:JAW
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MING
Other - Middle Name:
Other - Last Name:TONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:2722 STATE HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-6817
Mailing Address - Country:US
Mailing Address - Phone:518-843-3784
Mailing Address - Fax:518-843-3784
Practice Address - Street 1:149 MARKET ST
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-3626
Practice Address - Country:US
Practice Address - Phone:518-842-8336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027174183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist