Provider Demographics
NPI:1568709608
Name:SHUKLA, SMITHA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SMITHA
Middle Name:
Last Name:SHUKLA
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 1:16 EAGLETON FARM RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4214
Mailing Address - Country:US
Mailing Address - Phone:215-860-5357
Mailing Address - Fax:
Practice Address - Street 1:16 EAGLETON FARM RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4214
Practice Address - Country:US
Practice Address - Phone:215-860-5357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041784L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist