Provider Demographics
NPI:1598110744
Name:ABRACZINSKAS, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:ABRACZINSKAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 N SHAMOKIN ST
Mailing Address - Street 2:
Mailing Address - City:SHAMOKIN
Mailing Address - State:PA
Mailing Address - Zip Code:17872-6719
Mailing Address - Country:US
Mailing Address - Phone:570-648-5242
Mailing Address - Fax:570-648-3606
Practice Address - Street 1:605 N SHAMOKIN ST
Practice Address - Street 2:
Practice Address - City:SHAMOKIN
Practice Address - State:PA
Practice Address - Zip Code:17872-6719
Practice Address - Country:US
Practice Address - Phone:570-648-5242
Practice Address - Fax:570-648-3606
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA034627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist