Provider Demographics
NPI:1003267022
Name:IYAHEN, SHARLEEN A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHARLEEN
Middle Name:A
Last Name:IYAHEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-1720
Mailing Address - Country:US
Mailing Address - Phone:203-327-4479
Mailing Address - Fax:203-975-0427
Practice Address - Street 1:296 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-1720
Practice Address - Country:US
Practice Address - Phone:203-327-4479
Practice Address - Fax:203-975-0427
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0013200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist