Provider Demographics
NPI:1467008631
Name:TANG, ANDY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:
Last Name:TANG
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 1:4766 ANACONDA RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-3811
Mailing Address - Country:US
Mailing Address - Phone:267-399-6633
Mailing Address - Fax:
Practice Address - Street 1:3401 N BROAD ST # B150
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5189
Practice Address - Country:US
Practice Address - Phone:215-707-4528
Practice Address - Fax:215-707-4873
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI040372001835P0018X, 1835X0200X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835X0200XPharmacy Service ProvidersPharmacistOncology
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care