Provider Demographics
NPI:1023393766
Name:NGUYEN, CHRISTINE MY (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MY
Last Name:NGUYEN
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 1:11 HUNTSBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-4376
Mailing Address - Country:US
Mailing Address - Phone:949-836-8088
Mailing Address - Fax:
Practice Address - Street 1:5 TREMONT ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3054
Practice Address - Country:US
Practice Address - Phone:508-824-5332
Practice Address - Fax:508-880-3856
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH27209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist