Provider Demographics
NPI:1134817943
Name:TAKAMURA, KEI (PHARMD)
Entity type:Individual
Prefix:
First Name:KEI
Middle Name:
Last Name:TAKAMURA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:
Other - Last Name:TAKAMURA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:374 8TH ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 6TH ST
Practice Address - Street 2:C/O PHARMACY DEPT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:650-450-3569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy