Provider Demographics
NPI:1366171449
Name:NGUYEN, NATALIE LAM QUYNH (RPH)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:LAM QUYNH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 JADE LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1614
Mailing Address - Country:US
Mailing Address - Phone:856-438-0487
Mailing Address - Fax:
Practice Address - Street 1:180 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9450
Practice Address - Country:US
Practice Address - Phone:856-983-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045707L183500000X
NJ28RI03186500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist