MEDICARE: TRINH TU TRIEU RPH

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	047617	NY

General Provider Information

NPI Number	:	1629116603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINH TU TRIEU RPH

Provider Business Mailing Address
First Line	:	2112B 36TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-4422
Country	:	US
Telephone Number	:	718-606-0068
Fax Number	:	718-606-0069

Provider Business Practice Location Address
First Line	:	2112B 36TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-4422
Country	:	US
Telephone Number	:	718-606-0068
Fax Number	:	718-606-0069

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/08/2007

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