Provider Demographics
NPI:1033712609
Name:NGUYEN, HUYEN T (RPH)
Entity Type:Individual
Prefix:MS
First Name:HUYEN
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 ROLLSTONE RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-5350
Mailing Address - Country:US
Mailing Address - Phone:978-342-8740
Mailing Address - Fax:978-345-9955
Practice Address - Street 1:57 ROLLSTONE RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-5350
Practice Address - Country:US
Practice Address - Phone:978-342-8740
Practice Address - Fax:978-345-9955
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23324183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1609975994OtherCVS