Provider Demographics
NPI:1215337514
Name:ODERA, ZILPA
Entity type:Individual
Prefix:
First Name:ZILPA
Middle Name:
Last Name:ODERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MAKEFIELD RD
Mailing Address - Street 2:UNIT G295
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5011
Mailing Address - Country:US
Mailing Address - Phone:302-743-2893
Mailing Address - Fax:
Practice Address - Street 1:2435 STREET RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2894
Practice Address - Country:US
Practice Address - Phone:215-639-6711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist