Provider Demographics
NPI:1467784371
Name:OLUIKPE, OMENIHU BENSON (RPH)
Entity Type:Individual
Prefix:MR
First Name:OMENIHU
Middle Name:BENSON
Last Name:OLUIKPE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 SHALIMAR DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-4332
Mailing Address - Country:US
Mailing Address - Phone:585-262-3760
Mailing Address - Fax:
Practice Address - Street 1:222 ALEXANDER ST
Practice Address - Street 2:SUITE 2700
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-4039
Practice Address - Country:US
Practice Address - Phone:585-262-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20 047876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20 047876OtherSTATE EDUCATION DEPARTMENT, OFFICE OF PROFESSIONS