Provider Demographics
NPI:1548925035
Name:HUANG, EDITH MIN (PHARMD)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:MIN
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 1:14807 RYDELL RD APT 303
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-4458
Mailing Address - Country:US
Mailing Address - Phone:919-259-2632
Mailing Address - Fax:
Practice Address - Street 1:5841 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-2923
Practice Address - Country:US
Practice Address - Phone:703-536-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist