Provider Demographics
NPI:1164289575
Name:LE-KONG, UYEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:UYEN
Middle Name:
Last Name:LE-KONG
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 1:1558 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-5033
Mailing Address - Country:US
Mailing Address - Phone:617-566-2281
Mailing Address - Fax:617-232-4084
Practice Address - Street 1:1558 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-5033
Practice Address - Country:US
Practice Address - Phone:617-566-2281
Practice Address - Fax:617-232-4084
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH25705183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist