Provider Demographics
NPI:1568079457
Name:HUANG, ALEXIS S (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ALEXIS
Middle Name:S
Last Name:HUANG
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 1:8 TIMBERBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-2130
Mailing Address - Country:US
Mailing Address - Phone:609-529-8258
Mailing Address - Fax:
Practice Address - Street 1:1801 N OLDEN AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638-3108
Practice Address - Country:US
Practice Address - Phone:609-493-9902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04076100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RJ08664OtherIMMUNIZATION LICENSE
NJ28RI04076100OtherPHARMACIST LICENSE