Provider Demographics
NPI:1841647658
Name:LE, HAN N (PHARMACIST)
Entity type:Individual
Prefix:
First Name:HAN
Middle Name:N
Last Name:LE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 NIZAM DR
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-4016
Mailing Address - Country:US
Mailing Address - Phone:508-868-4755
Mailing Address - Fax:508-363-4977
Practice Address - Street 1:50 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-2350
Practice Address - Country:US
Practice Address - Phone:508-363-4570
Practice Address - Fax:508-363-4977
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-22
Last Update Date:2016-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist