Provider Demographics
NPI:1720715980
Name:KUANG, PENNY (PHARMD)
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:
Last Name:KUANG
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 1:260 PERIMETER DR UNIT 412
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-8058
Mailing Address - Country:US
Mailing Address - Phone:734-757-0249
Mailing Address - Fax:
Practice Address - Street 1:82 PEARL ST
Practice Address - Street 2:
Practice Address - City:ESSEX JCT
Practice Address - State:VT
Practice Address - Zip Code:05452-3642
Practice Address - Country:US
Practice Address - Phone:802-878-5351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-06
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0134577183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist