Provider Demographics
NPI:1770450629
Name:HSU, ALICE JENH (PHARMD)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:JENH
Last Name:HSU
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 1:2209 SAMANTHA WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1718
Mailing Address - Country:US
Mailing Address - Phone:908-463-1148
Mailing Address - Fax:
Practice Address - Street 1:2209 SAMANTHA WAY
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-1718
Practice Address - Country:US
Practice Address - Phone:908-463-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD184371835I0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835I0206XPharmacy Service ProvidersPharmacistInfectious Diseases