Healthcare Provider Details

I. General information

NPI: 1710812904
Provider Name (Legal Business Name): ANH NHU PHAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 COMMONWEALTH AVE
BOSTON MA
02215-1274
US

IV. Provider business mailing address

34 WHEELER ST
MALDEN MA
02148-4733
US

V. Phone/Fax

Practice location:
  • Phone: 617-323-4440
  • Fax:
Mailing address:
  • Phone: 978-631-7712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPH1001017
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: