Provider Demographics
NPI:1992074587
Name:NGUYEN, MY LIEN (PHARMD, PHD)
Entity type:Individual
Prefix:
First Name:MY LIEN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564
Mailing Address - Country:US
Mailing Address - Phone:585-425-2300
Mailing Address - Fax:
Practice Address - Street 1:7500 COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564
Practice Address - Country:US
Practice Address - Phone:585-425-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058987183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist