Healthcare Provider Details

I. General information

NPI: 1114783388
Provider Name (Legal Business Name): HIEN NGUYEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 02/27/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 WASHINGTON AVE
HILLSDALE NJ
07642
US

IV. Provider business mailing address

50 HORIZON FARMS DR
WARWICK NY
10990-2260
US

V. Phone/Fax

Practice location:
  • Phone: 201-664-4250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1592675
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02213000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: