Provider Demographics
NPI:1518489632
Name:CHANG, RICHARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:CHANG
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 1:96 GOODWIN PKWY
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9447
Mailing Address - Country:US
Mailing Address - Phone:856-745-1844
Mailing Address - Fax:
Practice Address - Street 1:228 STRAWBRIDGE DR
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-4600
Practice Address - Country:US
Practice Address - Phone:856-242-2554
Practice Address - Fax:856-581-8912
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15220183500000X
PARP450485183500000X
NJ28RI03376100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist