Provider Demographics
NPI:1750697066
Name:NGUYEN, TUYEN THE (RPH)
Entity type:Individual
Prefix:
First Name:TUYEN
Middle Name:THE
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2734
Mailing Address - Country:US
Mailing Address - Phone:215-657-1267
Mailing Address - Fax:
Practice Address - Street 1:6101 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-1931
Practice Address - Country:US
Practice Address - Phone:215-924-9645
Practice Address - Fax:215-924-0547
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist