Healthcare Provider Details

I. General information

NPI: 1831008812
Provider Name (Legal Business Name): AKSHAY MOLEKUDY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHIEF EDDIE HOFFMAN HWY
BETHEL AK
99559-4103
US

IV. Provider business mailing address

1010 NORTH ST
GREENWICH CT
06831-2731
US

V. Phone/Fax

Practice location:
  • Phone: 97-543-6442
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number257027
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: