Provider Demographics
NPI:1720329501
Name:HENOK, JUSTINA NUUGWANGA N (PHARM)
Entity Type:Individual
Prefix:
First Name:JUSTINA
Middle Name:NUUGWANGA N
Last Name:HENOK
Suffix:
Gender:F
Credentials:PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 14TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6820
Mailing Address - Country:US
Mailing Address - Phone:202-332-4865
Mailing Address - Fax:
Practice Address - Street 1:3031 14TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-6820
Practice Address - Country:US
Practice Address - Phone:202-332-4865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH100000755183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist