Provider Demographics
NPI:1548675689
Name:NGUYEN, JOANNE LE (PHARMD)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:LE
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 W LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-3425
Mailing Address - Country:US
Mailing Address - Phone:215-425-3784
Mailing Address - Fax:215-425-0740
Practice Address - Street 1:260 W LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-3425
Practice Address - Country:US
Practice Address - Phone:215-425-3784
Practice Address - Fax:215-425-0740
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443955183500000X
PARPI001699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist