Provider Demographics
NPI:1871603589
Name:MOKA, NDIDIAMAKA (PHARM D)
Entity type:Individual
Prefix:
First Name:NDIDIAMAKA
Middle Name:
Last Name:MOKA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 RAMUNDO CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-6501
Mailing Address - Country:US
Mailing Address - Phone:513-233-0205
Mailing Address - Fax:
Practice Address - Street 1:3200 VINE ST
Practice Address - Street 2:PHARMACY SERVICE 119
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2213
Practice Address - Country:US
Practice Address - Phone:513-861-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-27413183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy