Provider Demographics
NPI:1679746606
Name:HA, CHI HUNG (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:CHI HUNG
Middle Name:
Last Name:HA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:MR
Other - First Name:ANDREW
Other - Middle Name:
Other - Last Name:HA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1420 BATH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3805
Mailing Address - Country:US
Mailing Address - Phone:718-256-3288
Mailing Address - Fax:
Practice Address - Street 1:326 LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1002
Practice Address - Country:US
Practice Address - Phone:718-422-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist