Provider Demographics
NPI:1477733137
Name:DIEP, WINNIE HANG (PHARMD)
Entity Type:Individual
Prefix:
First Name:WINNIE
Middle Name:HANG
Last Name:DIEP
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 1:4203 247TH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1642
Mailing Address - Country:US
Mailing Address - Phone:646-250-5859
Mailing Address - Fax:
Practice Address - Street 1:8213 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7011
Practice Address - Country:US
Practice Address - Phone:718-565-1473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-10
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00267643Medicaid