Provider Demographics
NPI:1740302264
Name:EAPEN, NEENA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NEENA
Middle Name:
Last Name:EAPEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:NEENA
Other - Middle Name:
Other - Last Name:EAPEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8232 CORNERSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6294
Mailing Address - Country:US
Mailing Address - Phone:410-799-2609
Mailing Address - Fax:410-799-2609
Practice Address - Street 1:55 WADE AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4663
Practice Address - Country:US
Practice Address - Phone:410-402-7696
Practice Address - Fax:410-402-7990
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158201835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy