Individual provider Active NPI

Tiffany Abena Manu Boakye, PHARMD.

  • Pharmacist
  • Fairfax Station, VA
National Provider Identifier
1295070613
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202211798 Issued in VA
Practice address
7936 Bressingham Dr
Fairfax Station, VA 22039-3157
Phone
(703) 495-9749
NPI assigned
Dec 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202211798 VA Primary

Addresses

Primary practice location

7936 Bressingham Dr
Fairfax Station, VA 22039-3157

Mailing address

7936 Bressingham Dr
Fairfax Station, VA 22039-3157
Phone (703) 495-9749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0202211798VAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1295070613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7936 BRESSINGHAM DR",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220393157",
            "telephone_number": "703-495-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7936 BRESSINGHAM DR",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220393157",
            "telephone_number": "703-495-9749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAKYE",
        "first_name": "TIFFANY",
        "middle_name": "ABENA MANU",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202211798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax Station, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.