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General NPI Number Information
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NPI Number | 1356175582
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Entity Type | Individual
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Provider Name | LORETTA TAKYIWA-MENSAH PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/29/2024
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 732 ALLERTON AVE
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City | BRONX
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State | NY
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Zip | 10467-8702
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Country | US
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Telephone | 718-516-0572
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Fax |
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Provider Business Mailing Address
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Address Line | 2068 WASHINGTON AVE APT 1
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City | BRONX
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State | NY
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Zip | 10457-3282
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Country | US
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Telephone | 917-502-8995
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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 | 068168
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License Number State | NY
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