Provider Demographics
NPI:1922398122
Name:NGHIEM, ROBYN (RPH)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:NGHIEM
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 1:255 CURTISS ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-1705
Mailing Address - Country:US
Mailing Address - Phone:860-628-2444
Mailing Address - Fax:860-621-6497
Practice Address - Street 1:167 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2505
Practice Address - Country:US
Practice Address - Phone:860-628-2444
Practice Address - Fax:860-621-6497
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2011-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8009183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT8009OtherSTATE LICENSE