Provider Demographics
NPI:1740990381
Name:NGUYEN, NHI HOANG PHUONG (RPH)
Entity type:Individual
Prefix:DR
First Name:NHI
Middle Name:HOANG PHUONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 SUMMIT AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-7514
Mailing Address - Country:US
Mailing Address - Phone:774-261-2054
Mailing Address - Fax:
Practice Address - Street 1:575 E ORDNANCE RD
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-6555
Practice Address - Country:US
Practice Address - Phone:410-590-5601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH241263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS94280227OtherDRIVER'S LICENSE