Provider Demographics
NPI:1447633409
Name:EYISI, UCHECHUKWU JANET (PHARMD)
Entity type:Individual
Prefix:
First Name:UCHECHUKWU
Middle Name:JANET
Last Name:EYISI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 HARRY S TRUMAN DR
Mailing Address - Street 2:APT 407
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2073
Mailing Address - Country:US
Mailing Address - Phone:267-455-2329
Mailing Address - Fax:
Practice Address - Street 1:6260 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4258
Practice Address - Country:US
Practice Address - Phone:301-934-9564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist