Provider Demographics
NPI:1699822437
Name:OBIJURU, CECILIA C (RPH)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:C
Last Name:OBIJURU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 DOUGLASS ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-1830
Mailing Address - Country:US
Mailing Address - Phone:212-932-6588
Mailing Address - Fax:212-662-2011
Practice Address - Street 1:215 W 125TH ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4426
Practice Address - Country:US
Practice Address - Phone:212-932-6588
Practice Address - Fax:212-662-2011
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist