Individual provider Active NPI

Victor Nhan Thanh Nguyen, PHARM.D

  • Pharmacist
  • Cortland, NY
National Provider Identifier
1023294923
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
049742 Issued in NY
Practice address
3948 Route 281
Cortland, NY 13045-8851
Phone
(607) 756-8489
Fax
(607) 756-8495
NPI assigned
Jan 10, 2008
Last updated
Mar 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16982 MD
Pharmacist 183500000X 28RI02861200 NJ
Pharmacist 183500000X RP437867 PA
Pharmacist 183500000X 049742 NY Primary

Addresses

Primary practice location

3948 Route 281
Cortland, NY 13045-8851

Mailing address

3948 Route 281
Cortland, NY 13045-8851
Phone (607) 756-8489

Other identifiers 1

IdentifierTypeStateIssuer
02668353MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI02861200NJMDPharmacist
049742NYMDPharmacist
RP437867PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 6, 2022 Accepting new patients
Walgreen Co PastSince Mar 21, 2021 Accepting new patients

Locations

3948 State Route 281
Cortland, NY 13045
Phone (607) 756-8489

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1023294923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 ROUTE 281",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130458851",
            "telephone_number": "607-756-8489",
            "fax_number": "607-756-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3948 ROUTE 281",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130458851",
            "telephone_number": "607-756-8489",
            "fax_number": "607-756-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VICTOR NHAN",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-10",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "16982",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02861200",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP437867",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "049742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02668353",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.