Provider Demographics
NPI:1396626727
Name:DO, THUY VAN TRUONG (PHARMD)
Entity type:Individual
Prefix:
First Name:THUY
Middle Name:VAN TRUONG
Last Name:DO
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 1:399 REVOLUTION DR STE 1010
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1582
Mailing Address - Country:US
Mailing Address - Phone:978-354-4694
Mailing Address - Fax:978-354-3166
Practice Address - Street 1:399 REVOLUTION DR STE 1010
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-1582
Practice Address - Country:US
Practice Address - Phone:978-354-4694
Practice Address - Fax:978-354-3166
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH268501835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care