Provider Demographics
NPI:1477146249
Name:WANG, XIAOWEI (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:XIAOWEI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FAIRFIELD BLVD UNIT C2
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-5903
Mailing Address - Country:US
Mailing Address - Phone:203-691-9169
Mailing Address - Fax:203-815-1661
Practice Address - Street 1:10 FAIRFIELD BLVD UNIT C2
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-5903
Practice Address - Country:US
Practice Address - Phone:203-691-9169
Practice Address - Fax:203-815-1661
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0014038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist