Provider Demographics
NPI:1366076846
Name:HUANG, FANG ZAI (PHARMD)
Entity type:Individual
Prefix:
First Name:FANG
Middle Name:ZAI
Last Name:HUANG
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 1:2950 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-3228
Mailing Address - Country:US
Mailing Address - Phone:414-332-1901
Mailing Address - Fax:
Practice Address - Street 1:2950 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-3228
Practice Address - Country:US
Practice Address - Phone:414-332-1901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19007-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist