Provider Demographics
NPI:1669299772
Name:LE, THY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:THY
Middle Name:
Last Name:LE
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 1:44110 ASHBURN SHOPPING PLZ
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3999
Mailing Address - Country:US
Mailing Address - Phone:703-729-3878
Mailing Address - Fax:844-411-6540
Practice Address - Street 1:44110 ASHBURN SHOPPING PLZ
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3999
Practice Address - Country:US
Practice Address - Phone:703-729-3878
Practice Address - Fax:844-411-6540
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202222340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist