Provider Demographics
NPI:1700256815
Name:HUYNH, NGA NGOC (PHARMD)
Entity Type:Individual
Prefix:
First Name:NGA
Middle Name:NGOC
Last Name:HUYNH
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 1:42758 LOCKLEAR TER
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIDING
Mailing Address - State:VA
Mailing Address - Zip Code:20152-6632
Mailing Address - Country:US
Mailing Address - Phone:703-327-9350
Mailing Address - Fax:
Practice Address - Street 1:42758 LOCKLEAR TER
Practice Address - Street 2:
Practice Address - City:SOUTH RIDING
Practice Address - State:VA
Practice Address - Zip Code:20152-6632
Practice Address - Country:US
Practice Address - Phone:703-327-9350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist