Provider Demographics
NPI:1659905214
Name:AKENA, MIGUEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:
Last Name:AKENA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 MINDY LN
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5960
Mailing Address - Country:US
Mailing Address - Phone:908-705-7264
Mailing Address - Fax:
Practice Address - Street 1:865 W GRAND ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1001
Practice Address - Country:US
Practice Address - Phone:908-558-0049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-23
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03570000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist