Provider Demographics
NPI:1700060597
Name:MIEU, HUONG TUYET (PHARMD)
Entity type:Individual
Prefix:PROF
First Name:HUONG
Middle Name:TUYET
Last Name:MIEU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 COLUMBIA TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-1610
Mailing Address - Country:US
Mailing Address - Phone:518-479-4230
Mailing Address - Fax:
Practice Address - Street 1:614 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-1610
Practice Address - Country:US
Practice Address - Phone:518-479-4230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049470183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00570618Medicaid