Provider Demographics
NPI:1982118089
Name:NGWA, BRIDGET ALIA (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:ALIA
Last Name:NGWA
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ATHENRY CT APT 101
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-7974
Mailing Address - Country:US
Mailing Address - Phone:352-682-8374
Mailing Address - Fax:
Practice Address - Street 1:1510 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3814
Practice Address - Country:US
Practice Address - Phone:410-484-0196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD249651835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist