Provider Demographics
NPI:1013516970
Name:AKANDE, TEJUMADE BISOYE (PHARMD)
Entity type:Individual
Prefix:
First Name:TEJUMADE
Middle Name:BISOYE
Last Name:AKANDE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 CONSHOHOCKEN AVE APT 809
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-5528
Mailing Address - Country:US
Mailing Address - Phone:732-599-8823
Mailing Address - Fax:
Practice Address - Street 1:704 E PASSYUNK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-3017
Practice Address - Country:US
Practice Address - Phone:215-627-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP455160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist