Provider Demographics
NPI:1720492176
Name:DUONG, NANCY THI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:THI
Last Name:DUONG
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 1:132 HEMLOCK CT
Mailing Address - Street 2:APT. C
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2929
Mailing Address - Country:US
Mailing Address - Phone:609-605-9061
Mailing Address - Fax:
Practice Address - Street 1:18 BOULDEN CIR
Practice Address - Street 2:SUITE 22
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3494
Practice Address - Country:US
Practice Address - Phone:302-322-0219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0004505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist