Provider Demographics
NPI:1841894557
Name:NGUYEN, TRACY N (RPH)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:N
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 1:8565 ALLENTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:BLANDON
Mailing Address - State:PA
Mailing Address - Zip Code:19510-9463
Mailing Address - Country:US
Mailing Address - Phone:610-916-2499
Mailing Address - Fax:
Practice Address - Street 1:8565 ALLENTOWN PIKE
Practice Address - Street 2:
Practice Address - City:BLANDON
Practice Address - State:PA
Practice Address - Zip Code:19510-9463
Practice Address - Country:US
Practice Address - Phone:610-916-2499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist