Neha Susan Abraham

Individual provider Active NPI Pharmacist · Hayward, CA

NPI 1699375279 · NPPES record last updated Jan 13, 2023

Key facts

NPI
1699375279
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
18314 (OK)
Practice address
1138 W Tennyson Rd
Hayward, CA 94544-4422
Phone
(510) 293-9031
NPI assigned
Oct 31, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
86908CAMDPharmacist
18314OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East, LP Past
since Nov 1, 2020
Accepting new patients
Wal-Mart Stores East LP Past
since Nov 1, 2020
Accepting new patients
Walgreen Co Past
since Jan 15, 2023
Accepting new patients
Walgreen Co Past
since Jan 15, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 86908 CA
Pharmacist 183500000X 18314 OK Yes

Addresses

Primary practice location

1138 W Tennyson Rd
Hayward, CA 94544-4422

Mailing address

1170 Beethoven CMN Unit 300
Fremont, CA 94538-5613
Phone (405) 226-1389

Other providers in Hayward, CA

All providers in Hayward, CA · Pharmacist in California

Sources for this page

Verify at the official NPI Registry.