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General NPI Number Information
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NPI Number | 1255640355
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Entity Type | Individual
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Provider Name | VINH DAM PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 10/07/2010
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Last Update Date | 10/07/2010
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Provider Practice Location Address
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Address Line | 77-105 BLOOMFIELD AVE
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-5985
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Country | US
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Telephone | 973-259-9290
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Fax |
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Provider Business Mailing Address
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Address Line | 78 FERRY ST FLOOR 2 APT #1
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City | NEWARK
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State | NJ
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Zip | 07105
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Country | US
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Telephone | 949-705-8386
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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 | 28RS00570900
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License Number State | NJ
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