Provider Demographics
NPI:1477734044
Name:SHEEN, EDWARD ALAN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ALAN
Last Name:SHEEN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 JUNIPER RD FL 1
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1452
Mailing Address - Country:US
Mailing Address - Phone:718-225-2999
Mailing Address - Fax:
Practice Address - Street 1:52 JUNIPER RD FL 1
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1452
Practice Address - Country:US
Practice Address - Phone:718-225-2999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist