Provider Demographics
NPI:1235538430
Name:MUSAKA, DEANA (PHARM'D)
Entity Type:Individual
Prefix:
First Name:DEANA
Middle Name:
Last Name:MUSAKA
Suffix:
Gender:F
Credentials:PHARM'D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 UNRUH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-2419
Mailing Address - Country:US
Mailing Address - Phone:267-844-0200
Mailing Address - Fax:
Practice Address - Street 1:2721 UNRUH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-2419
Practice Address - Country:US
Practice Address - Phone:267-844-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist