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General NPI Number Information
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NPI Number | 1861006256
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Entity Type | Individual
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Provider Name | TU PHAM
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Gender | Male
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 310 MAIN ST
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City | HAVERHILL
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State | MA
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Zip | 01830-5045
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Country | US
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Telephone | 978-521-4671
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Fax |
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Provider Business Mailing Address
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Address Line | 95 LINWOOD AVE
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City | NEWTON
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State | MA
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Zip | 02460-1425
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Country | US
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Telephone | 503-750-1804
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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 | PH239701
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License Number State | MA
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