Provider Demographics
NPI:1497015275
Name:DANG, DIANA THU NGA (RPH)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:THU NGA
Last Name:DANG
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 1:102 OAK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5954
Mailing Address - Country:US
Mailing Address - Phone:443-567-6598
Mailing Address - Fax:
Practice Address - Street 1:102 OAK VALLEY DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-5954
Practice Address - Country:US
Practice Address - Phone:443-567-6598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist