Provider Demographics
NPI:1982986188
Name:YUAN, TIAN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TIAN
Middle Name:
Last Name:YUAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2282 NASH CT
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-3831
Mailing Address - Country:US
Mailing Address - Phone:201-421-6919
Mailing Address - Fax:
Practice Address - Street 1:383 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-2735
Practice Address - Country:US
Practice Address - Phone:201-664-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03370200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist