Provider Demographics
NPI:1811229784
Name:TANG, SOKUNTHEA SAMANTHA (PHARMD)
Entity type:Individual
Prefix:MS
First Name:SOKUNTHEA
Middle Name:SAMANTHA
Last Name:TANG
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 1:6 TROTTERS TRL
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6626
Mailing Address - Country:US
Mailing Address - Phone:845-708-5494
Mailing Address - Fax:
Practice Address - Street 1:393 WINDSOR HWY
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7986
Practice Address - Country:US
Practice Address - Phone:845-561-0064
Practice Address - Fax:845-561-1607
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053550183500000X
NJ28RI03121000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist