Provider Demographics
NPI:1205038346
Name:MALLEY, SHARON (RPH)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:MALLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 STATE RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-5177
Mailing Address - Country:US
Mailing Address - Phone:508-833-8819
Mailing Address - Fax:508-833-2756
Practice Address - Street 1:2260 STATE RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-5177
Practice Address - Country:US
Practice Address - Phone:508-833-8819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25285183500000X
RI4144183500000X
CA52146183500000X
AZ12710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist