Healthcare Provider Details

I. General information

NPI: 1972430445
Provider Name (Legal Business Name): HANEEFAT OLUWASEUN ADELAKUN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 ACADEMY AVE
PROVIDENCE RI
02908-4148
US

IV. Provider business mailing address

295 ACADEMY AVE
PROVIDENCE RI
02908-4148
US

V. Phone/Fax

Practice location:
  • Phone: 401-273-7675
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH06861
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: