Provider Demographics
NPI:1073102554
Name:DIEP, LYNN VINH (PHARMD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:VINH
Last Name:DIEP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LYNN
Other - Middle Name:VINH
Other - Last Name:DIEP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1417
Mailing Address - Country:US
Mailing Address - Phone:617-212-8243
Mailing Address - Fax:
Practice Address - Street 1:833 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4701
Practice Address - Country:US
Practice Address - Phone:781-643-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH27642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist