Provider Demographics
NPI:1609477967
Name:ASUZU, NONYELUM
Entity Type:Individual
Prefix:
First Name:NONYELUM
Middle Name:
Last Name:ASUZU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:EDDYSTONE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1386
Mailing Address - Country:US
Mailing Address - Phone:610-447-1871
Mailing Address - Fax:
Practice Address - Street 1:1570 CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:EDDYSTONE
Practice Address - State:PA
Practice Address - Zip Code:19022-1386
Practice Address - Country:US
Practice Address - Phone:610-447-1871
Practice Address - Fax:610-447-1873
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist