Provider Demographics
NPI:1770852618
Name:LE, DI NGOC-QUYEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DI
Middle Name:NGOC-QUYEN
Last Name:LE
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 1:311 E 54TH ST APT 3D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4925
Mailing Address - Country:US
Mailing Address - Phone:858-531-9298
Mailing Address - Fax:
Practice Address - Street 1:1294 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1104
Practice Address - Country:US
Practice Address - Phone:212-996-3000
Practice Address - Fax:212-410-7516
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0564091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist