Provider Demographics
NPI:1841894268
Name:NGUYEN, CECILIA YEN
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:YEN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 BEALT ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170
Mailing Address - Country:US
Mailing Address - Phone:617-471-7451
Mailing Address - Fax:617-472-7174
Practice Address - Street 1:42 BEALE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02170-2617
Practice Address - Country:US
Practice Address - Phone:617-471-7451
Practice Address - Fax:617-472-7174
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH234031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist