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NPI Code Detail

MEDICARE: DR. TIANN CAMPBELL EFFIONG PHARM.D., RPH

MEDICARE: DR. TIANN CAMPBELL EFFIONG PHARM.D., RPH
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
1183500000XPharmacistPS0039892FL
2183500000XPharmacistI063847NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1584305OTHERNYGENOA HEALTHCARE - SITE 20421 NCPDP

General Provider Information

NPI Number : 1578658704
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIANN CAMPBELL EFFIONG PHARM.D., RPH
Provider Business Mailing Address
First Line : 1623 FLATBUSH AVE
Second Line : LOCATED WITHIN CATHOLIC CHARITIES OF BROOKLYN & QUEENS
City : BROOKLYN
State : NY
Zip : 11210-3262
Country : US
Telephone Number : 347-410-7686
Fax Number : 347-269-1128
Provider Business Practice Location Address
First Line : 1623 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-3262
Country : US
Telephone Number : 347-410-7686
Fax Number : 347-269-1128
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 08/22/2022

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