Provider Demographics
NPI:1881468247
Name:AKA, JULIANA
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:AKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 CHERRYWOOD LN APT 2210
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-0832
Mailing Address - Country:US
Mailing Address - Phone:443-813-5463
Mailing Address - Fax:
Practice Address - Street 1:15100 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4602
Practice Address - Country:US
Practice Address - Phone:301-776-5404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist