Provider Demographics
NPI:1235918061
Name:NGUYEN, UYEN T
Entity Type:Individual
Prefix:
First Name:UYEN
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 FAIRFIELD RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-2515
Mailing Address - Country:US
Mailing Address - Phone:267-393-6790
Mailing Address - Fax:
Practice Address - Street 1:8500 NEW FALLS RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19054-1636
Practice Address - Country:US
Practice Address - Phone:215-943-3694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457885183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist