Provider Demographics
NPI:1871197004
Name:OAKES, TANYA (RPH)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:OAKES
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 1:403 N DELAVAN AVE
Mailing Address - Street 2:
Mailing Address - City:MARGATE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08402-1911
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1901 W OREGON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4200
Practice Address - Country:US
Practice Address - Phone:215-551-8265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-044813-L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist