Provider Demographics
NPI:1467742239
Name:DANG, KAREN Q (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:Q
Last Name:DANG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-2613
Mailing Address - Country:US
Mailing Address - Phone:860-666-4079
Mailing Address - Fax:860-666-8818
Practice Address - Street 1:3 COBBLE CT
Practice Address - Street 2:
Practice Address - City:UNIONVILLE
Practice Address - State:CT
Practice Address - Zip Code:06085-1593
Practice Address - Country:US
Practice Address - Phone:860-404-3041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist