Provider Demographics
NPI:1801349543
Name:CHONG, SUZIE MINHEE (PHARMD)
Entity type:Individual
Prefix:
First Name:SUZIE
Middle Name:MINHEE
Last Name:CHONG
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 1:601 OLD LANDING RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-4324
Mailing Address - Country:US
Mailing Address - Phone:757-897-8928
Mailing Address - Fax:
Practice Address - Street 1:4813 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3727
Practice Address - Country:US
Practice Address - Phone:757-826-2792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202215159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist