Provider Demographics
NPI:1659156867
Name:NDIANEFO, LILIAN CHIKA
Entity Type:Individual
Prefix:
First Name:LILIAN
Middle Name:CHIKA
Last Name:NDIANEFO
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 1:101 MUSES CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-9616
Mailing Address - Country:US
Mailing Address - Phone:919-880-4267
Mailing Address - Fax:
Practice Address - Street 1:5111 WAKE FOREST RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-3704
Practice Address - Country:US
Practice Address - Phone:919-957-4512
Practice Address - Fax:919-957-4538
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist