Provider Demographics
NPI:1255561445
Name:DIEP, ANH THAI (RPH)
Entity type:Individual
Prefix:
First Name:ANH
Middle Name:THAI
Last Name:DIEP
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E 167TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-4024
Mailing Address - Country:US
Mailing Address - Phone:718-538-4754
Mailing Address - Fax:718-538-4802
Practice Address - Street 1:235 E 167TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-4024
Practice Address - Country:US
Practice Address - Phone:718-538-4754
Practice Address - Fax:718-538-4802
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist