Provider Demographics
NPI:1306163068
Name:TRAN, NHAT QUANG (RPH)
Entity type:Individual
Prefix:
First Name:NHAT
Middle Name:QUANG
Last Name:TRAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ALDERBERRY CT
Mailing Address - Street 2:
Mailing Address - City:IVYLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18974-1686
Mailing Address - Country:US
Mailing Address - Phone:215-364-1905
Mailing Address - Fax:215-364-1905
Practice Address - Street 1:1 ICE CREAM ALLEY
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:215-579-0864
Practice Address - Fax:215-579-0560
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP043842L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist