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General NPI Number Information
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NPI Number | 1205124146
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Entity Type | Individual
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Provider Name | IRENE SEKYI NTIAKO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 07/13/2011
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Provider Practice Location Address
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Address Line | 1060 DRAGON RD APT. B
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City | OAKWOOD
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State | VA
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Zip | 24631-9210
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Country | US
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Telephone | 276-498-4190
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 JANEY RD APT. B
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City | OAKWOOD
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State | VA
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Zip | 24631-8953
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Country | US
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Telephone | 571-438-7692
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0203013578
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License Number State | VA
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