Provider Demographics
NPI:1588031264
Name:AWUGAH, LISA CAREN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:CAREN
Last Name:AWUGAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:CAREN
Other - Last Name:ACAMPORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:278 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3326
Mailing Address - Country:US
Mailing Address - Phone:203-239-2086
Mailing Address - Fax:203-239-1933
Practice Address - Street 1:278 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3326
Practice Address - Country:US
Practice Address - Phone:203-239-2086
Practice Address - Fax:203-239-1933
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0011359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist