MEDICARE: CHAU HA TRUONG PHARMD

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
1	183500000X	Pharmacist	053150	NY

General Provider Information

NPI Number	:	1508189556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAU HA TRUONG PHARMD

Provider Business Mailing Address
First Line	:	1738 77TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-1112
Country	:	US
Telephone Number	:	917-622-2415
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-4210
Country	:	US
Telephone Number	:	718-564-2380
Fax Number	:	718-564-2386

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	03/04/2010

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Directions to “ CHAU HA TRUONG PHARMD” Practice Location

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