MEDICARE: OLAWONUOLA ABIONA PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI03817100	NJ
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	28RI03817100	NJ

General Provider Information

NPI Number	:	1285118497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLAWONUOLA ABIONA PHARMD

Provider Business Mailing Address
First Line	:	1927 MARIA ELANA DR
Second Line	:
City	:	WILLIAMSTOWN
State	:	NJ
Zip	:	08094-3485
Country	:	US
Telephone Number	:	856-520-1525
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 WARREN ST
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12202-1603
Country	:	US
Telephone Number	:	856-520-1525
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	09/24/2018

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