Healthcare Provider Details

I. General information

NPI: 1578049847
Provider Name (Legal Business Name): TUYET NGOC HUYNH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 CENTRAL AVE NW
ALBUQUERQUE NM
87104-1605
US

IV. Provider business mailing address

12701 SINGING ARROW AVE SE APT D
ALBUQUERQUE NM
87123-3736
US

V. Phone/Fax

Practice location:
  • Phone: 505-242-2713
  • Fax: 505-766-6613
Mailing address:
  • Phone: 505-730-8457
  • Fax: 505-766-6613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00008920
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: