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General NPI Number Information
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NPI Number | 1891309068
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Entity Type | Individual
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Provider Name | IFUNANYA MBANEFO
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Gender | Female
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 30 HUNTER LN
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City | CAMP HILL
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State | PA
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Zip | 17011-2400
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Country | US
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Telephone | 717-761-2633
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Fax |
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Provider Business Mailing Address
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Address Line | 13 SANDALWOOD DR APT 9
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City | NEWARK
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State | DE
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Zip | 19713-4620
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Country | US
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Telephone |
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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 | A1-0005428
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License Number State | DE
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