Basic Information
| Provider Information | |||||||||
| NPI: | 1386162972 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TSANG | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 EAGLE POINT BLVD | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165111146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4438139790 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5515 PEACH ST | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165092603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148644031 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2017 | ||||||||
| LastUpdateDate: | 09/02/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P0018X | RP451890 | PA | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.