Provider Demographics
NPI:1639694433
Name:SHARMA, SHIVANI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHIVANI
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
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 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4758
Mailing Address - Country:US
Mailing Address - Phone:845-649-9339
Mailing Address - Fax:
Practice Address - Street 1:26 W MERRITT BLVD
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2243
Practice Address - Country:US
Practice Address - Phone:845-896-4055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063176183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist