Provider Demographics
NPI:1457186686
Name:NGUYEN, BICH THY HA (PHARMD)
Entity type:Individual
Prefix:
First Name:BICH THY
Middle Name:HA
Last Name:NGUYEN
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 1:226 S CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2342
Mailing Address - Country:US
Mailing Address - Phone:626-213-7967
Mailing Address - Fax:
Practice Address - Street 1:6410 PETRIE WAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3034
Practice Address - Country:US
Practice Address - Phone:410-686-7649
Practice Address - Fax:416-686-2457
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist