Provider Demographics
NPI:1417561234
Name:ESSUAH-MENSAH, TRACY SENYO (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:SENYO
Last Name:ESSUAH-MENSAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8713 FAIRHAVEN PL
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-9341
Mailing Address - Country:US
Mailing Address - Phone:240-482-9721
Mailing Address - Fax:
Practice Address - Street 1:8501 FORT SMALLWOOD RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-2607
Practice Address - Country:US
Practice Address - Phone:240-482-9721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26522183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD26522OtherMARYLAND BOARD OF PHARMACY