MISS Vivian W Fan

NPI #1720262835 in Ridgewood, New York

Provider Information

NPI Number: 1720262835
Entity Type: Individual
Name: MISS Vivian W Fan
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Dec 26, 2007
Last Updated: Dec 26, 2007

Practice Location

Address: 5508 METROPOLITAN AVE
City: Ridgewood
State: New York
ZIP Code: 11385-1221
Phone: (718) 418-3841

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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