Provider Demographics
NPI:1104458314
Name:AKINBAJO, DEANNA (PHARMD)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:AKINBAJO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:MOOREHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 HINCHLEY WOOD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1457
Mailing Address - Country:US
Mailing Address - Phone:585-503-6531
Mailing Address - Fax:
Practice Address - Street 1:5 SCIENCE PARK
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-1966
Practice Address - Country:US
Practice Address - Phone:203-497-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.00126041835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy