Provider Demographics
NPI:1275984551
Name:SHAWD, PATRICK CARL (PHARMD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:CARL
Last Name:SHAWD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WATER ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-3558
Mailing Address - Country:US
Mailing Address - Phone:212-825-0761
Mailing Address - Fax:212-385-9460
Practice Address - Street 1:200 WATER ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-3558
Practice Address - Country:US
Practice Address - Phone:212-825-0761
Practice Address - Fax:212-385-9460
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist