Provider Demographics
NPI:1891797684
Name:NGUYEN, TONY L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:L
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46-065 KONOHIKI ST
Mailing Address - Street 2:3666
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-6132
Mailing Address - Country:US
Mailing Address - Phone:808-554-8301
Mailing Address - Fax:808-432-3854
Practice Address - Street 1:45-602 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2017
Practice Address - Country:US
Practice Address - Phone:808-432-3853
Practice Address - Fax:808-432-3854
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-1194183500000X
CARPH38998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist