Healthcare Provider Details

I. General information

NPI: 1205754611
Provider Name (Legal Business Name): JESSICA NWABUOKU PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2290 CENTRAL PARK AVE
YONKERS NY
10710-1216
US

IV. Provider business mailing address

2290 CENTRAL PARK AVE
YONKERS NY
10710-1216
US

V. Phone/Fax

Practice location:
  • Phone: 914-793-3933
  • Fax:
Mailing address:
  • Phone: 914-793-3933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number074070
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: