Provider Demographics
NPI:1770867616
Name:LEE, WANG SHIANG (PHARMD)
Entity Type:Individual
Prefix:
First Name:WANG
Middle Name:SHIANG
Last Name:LEE
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 1:1010 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-3244
Mailing Address - Country:US
Mailing Address - Phone:401-946-0337
Mailing Address - Fax:401-464-9740
Practice Address - Street 1:1010 PARK AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-3244
Practice Address - Country:US
Practice Address - Phone:401-946-0337
Practice Address - Fax:401-464-9740
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH04602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist