Provider Demographics
NPI:1770055840
Name:AKUBUO, CHIBUZO JUDE (PHARMD)
Entity type:Individual
Prefix:
First Name:CHIBUZO
Middle Name:JUDE
Last Name:AKUBUO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 S CEDAR CREST BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3600
Mailing Address - Country:US
Mailing Address - Phone:610-821-4560
Mailing Address - Fax:
Practice Address - Street 1:365 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3600
Practice Address - Country:US
Practice Address - Phone:610-821-4560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-29
Last Update Date:2018-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000000000OtherNON/A