Provider Demographics
NPI:1013529726
Name:NGUYEN, NEIL TUAN
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:TUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 NORWAY LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-9003
Mailing Address - Country:US
Mailing Address - Phone:267-788-5127
Mailing Address - Fax:717-273-2532
Practice Address - Street 1:230 S BROADWAY
Practice Address - Street 2:
Practice Address - City:PENNSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08070-2724
Practice Address - Country:US
Practice Address - Phone:856-678-2224
Practice Address - Fax:856-678-5102
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02650700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist