Provider Demographics
NPI:1194563940
Name:ONYEOKORO, JEFFREY (PHARMD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:ONYEOKORO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HIGH RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BOURNE
Mailing Address - State:MA
Mailing Address - Zip Code:02532-5668
Mailing Address - Country:US
Mailing Address - Phone:617-833-5372
Mailing Address - Fax:
Practice Address - Street 1:710 ROUTE 28
Practice Address - Street 2:
Practice Address - City:HARWICH PORT
Practice Address - State:MA
Practice Address - Zip Code:02646-1931
Practice Address - Country:US
Practice Address - Phone:774-237-9000
Practice Address - Fax:774-237-9001
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2329281835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty