Provider Demographics
NPI:1831407691
Name:NGO, THUY-TIEN T (PHARMD)
Entity type:Individual
Prefix:
First Name:THUY-TIEN
Middle Name:T
Last Name:NGO
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 1:12810 S. TRYON STREET
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-3325
Mailing Address - Country:US
Mailing Address - Phone:704-583-2033
Mailing Address - Fax:704-583-0359
Practice Address - Street 1:12810 S. TRYON STREET
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-3325
Practice Address - Country:US
Practice Address - Phone:704-583-2033
Practice Address - Fax:704-583-0359
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18372183500000X
SC11699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist