NPI Code Detail JSON Logo

1871197749 NPI number — MAI THANH NGUYEN PHARM D.

NPI Number: 1871197749
Health Care Provider/Practitioner: MAI THANH NGUYEN PHARM D.

Information about “1871197749” NPI (MAI THANH NGUYEN PHARM D.) exists in 1871197749 in HTML format HTML  |  1871197749 in plain Text format TXT  |  1871197749 in PDF (Portable Document Format) PDF  |  1871197749 in an XML format XML  formats.

NPI Number : 1871197749 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871197749",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NGUYEN",
    "FirstName": "MAI",
    "MiddleName": "THANH",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PHARM D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4711 LOGWOOD LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHANTILLY",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "20151-2459",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "703-217-0674",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11003 LEE HWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIRFAX",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22030-5002",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "571-432-5801",
    "PracticeLocationAddressFaxNumber": "571-432-5807",
    "EnumerationDate": "11/22/2020",
    "LastUpdateDate": "11/22/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "0202204856",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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