Provider Demographics
NPI:1578908406
Name:RIGGINS, SHARI L (RPH)
Entity Type:Individual
Prefix:MS
First Name:SHARI
Middle Name:L
Last Name:RIGGINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:SHARI
Other - Middle Name:L
Other - Last Name:RIVENBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:P.O.BOX 264
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077
Mailing Address - Country:US
Mailing Address - Phone:518-577-3043
Mailing Address - Fax:
Practice Address - Street 1:4000 FLORENCE DR
Practice Address - Street 2:BUILDING 1 SUITE 1316
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-5057
Practice Address - Country:US
Practice Address - Phone:518-577-3043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0362081835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist