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General NPI Number Information
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NPI Number | 1679741474
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Entity Type | Individual
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Provider Name | SAMUEL AKINLOLU TUGBIYELE RPH
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Gender | Male
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 957 UTICA AVE STE 2
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City | BROOKLYN
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State | NY
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Zip | 11203-4300
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Country | US
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Telephone | 347-461-9555
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Fax | 347-461-9556
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Provider Business Mailing Address
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Address Line | 957 UTICA AVE LIVINGWORD PHARMACY INC.
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City | BROOKLYN
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State | NY
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Zip | 11203-4397
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Country | US
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Telephone | 347-461-9555
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Fax | 347-461-9556
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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 | 039639
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License Number State | NY
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