Provider Demographics
NPI:1780127522
Name:SSEKAJJA, ANDREW (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:SSEKAJJA
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 1:5877 S DUQUESNE CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1373
Mailing Address - Country:US
Mailing Address - Phone:720-935-7364
Mailing Address - Fax:
Practice Address - Street 1:5877 S DUQUESNE CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1373
Practice Address - Country:US
Practice Address - Phone:720-935-7364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0021581183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPHA.0021561OtherPHARMACIST LICENSE COLORADO STATE BOARD OF PHARMACY