Provider Demographics
NPI:1497926760
Name:LAI, HIEN NGOC (PHARMD)
Entity Type:Individual
Prefix:
First Name:HIEN
Middle Name:NGOC
Last Name:LAI
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 1:10200 N ARMENIA AVENUE
Mailing Address - Street 2:APT # 2002
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612
Mailing Address - Country:US
Mailing Address - Phone:617-913-2592
Mailing Address - Fax:
Practice Address - Street 1:10200 N ARMENIA AVE
Practice Address - Street 2:APT # 2002
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7364
Practice Address - Country:US
Practice Address - Phone:617-913-2592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA250551835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy