Provider Demographics
NPI:1619680394
Name:AEGBUNIWE, SABRINA NNEKA
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:NNEKA
Last Name:AEGBUNIWE
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 1:601 GLEN ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:SEVEN VALLEYS
Mailing Address - State:PA
Mailing Address - Zip Code:17360-8985
Mailing Address - Country:US
Mailing Address - Phone:717-825-5895
Mailing Address - Fax:
Practice Address - Street 1:165 S RICHLAND AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-3558
Practice Address - Country:US
Practice Address - Phone:717-843-4730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist