Provider Demographics
NPI:1871813576
Name:NGUYEN, TRANG
Entity type:Individual
Prefix:
First Name:TRANG
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W CHASE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-4815
Mailing Address - Country:US
Mailing Address - Phone:410-752-4473
Mailing Address - Fax:410-752-6488
Practice Address - Street 1:250 W CHASE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4815
Practice Address - Country:US
Practice Address - Phone:410-752-4473
Practice Address - Fax:410-752-6488
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist