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General NPI Number Information
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NPI Number | 1003124488
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Entity Type | Individual
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Provider Name | JENNIFER L NGUYEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/19/2010
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 1331 E WYOMING AVE PHARMACY & NUTRITION SHOPPE
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City | PHILADELPHIA
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State | PA
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Zip | 19124-3808
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Country | US
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Telephone | 215-537-7626
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Fax | 215-737-7987
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Provider Business Mailing Address
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Address Line | 100 W OXFORD ST APT W124
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City | PHILADELPHIA
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State | PA
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Zip | 19122-3927
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18519
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP-045393-L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | A1-0003126
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License Number State | DE
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