Provider Demographics
NPI:1245607332
Name:NGUYEN, VICKY PHUONG KIM THI (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:VICKY
Middle Name:PHUONG KIM THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MS
Other - First Name:VICKY
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:298 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1850
Mailing Address - Country:US
Mailing Address - Phone:212-777-0740
Mailing Address - Fax:
Practice Address - Street 1:298 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-1850
Practice Address - Country:US
Practice Address - Phone:212-777-0740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist