Provider Demographics
NPI:1427635689
Name:NGUYEN-DANG, JULIA HAILY
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:HAILY
Last Name:NGUYEN-DANG
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 1:6781 GRAYSON RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-5138
Mailing Address - Country:US
Mailing Address - Phone:717-561-0587
Mailing Address - Fax:717-567-9942
Practice Address - Street 1:6781 GRAYSON RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-5138
Practice Address - Country:US
Practice Address - Phone:717-561-0587
Practice Address - Fax:717-567-9942
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042120L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist