Provider Demographics
NPI:1205124146
Name:NTIAKO, IRENE SEKYI (PHARMD)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:SEKYI
Last Name:NTIAKO
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 1:1210 JANEY RD
Mailing Address - Street 2:APT. B
Mailing Address - City:OAKWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:24631-8953
Mailing Address - Country:US
Mailing Address - Phone:571-438-7692
Mailing Address - Fax:
Practice Address - Street 1:1060 DRAGON RD
Practice Address - Street 2:APT. B
Practice Address - City:OAKWOOD
Practice Address - State:VA
Practice Address - Zip Code:24631-9210
Practice Address - Country:US
Practice Address - Phone:276-498-4190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0203013578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist