Provider Demographics
NPI:1497077143
Name:BUI, QUOC ANH (RPH)
Entity Type:Individual
Prefix:MR
First Name:QUOC
Middle Name:ANH
Last Name:BUI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 JACOBS LN
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2948
Mailing Address - Country:US
Mailing Address - Phone:203-948-4660
Mailing Address - Fax:
Practice Address - Street 1:3 JACOBS LN
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2948
Practice Address - Country:US
Practice Address - Phone:203-948-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8388183500000X
FLPS41156183500000X
NY050750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist