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NPI Code Detail

MEDICARE: HA NGUYEN

MEDICARE: HA NGUYEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH238505MA

General Provider Information

NPI Number : 1154926004
Entity Type Code : Individual
Provider Name (Legal Business Name) : HA NGUYEN
Provider Business Mailing Address
First Line : 6 MARSHVIEW TER
Second Line :
City : REVERE
State : MA
Zip : 02151-1034
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 27 MAIN ST
Second Line :
City : WATERTOWN
State : MA
Zip : 02472-4404
Country : US
Telephone Number : 617-926-6660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2020
Last Update Date : 11/30/2020

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Directions to “ HA NGUYEN ” Practice Location

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