Provider Demographics
NPI:1417620428
Name:YANG, MINXI (PHARMD)
Entity Type:Individual
Prefix:
First Name:MINXI
Middle Name:
Last Name:YANG
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 1:401 COOPER LANDING RD UNIT 503
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2536
Mailing Address - Country:US
Mailing Address - Phone:347-295-9166
Mailing Address - Fax:
Practice Address - Street 1:2 BROADWAY
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1206
Practice Address - Country:US
Practice Address - Phone:856-963-9311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03961400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist