Healthcare Provider Details

I. General information

NPI: 1558014670
Provider Name (Legal Business Name): DIANA NHI HOANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2721 STREET RD
BENSALEM PA
19020-2810
US

IV. Provider business mailing address

15 STEPHENSON WAY
HUNTINGDON VALLEY PA
19006-2227
US

V. Phone/Fax

Practice location:
  • Phone: 215-604-1390
  • Fax:
Mailing address:
  • Phone: 267-495-9649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP456519
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: