Provider Demographics
NPI:1710165584
Name:SHASKY, DIANE ANDRAKO (BSCIPHARM)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:ANDRAKO
Last Name:SHASKY
Suffix:
Gender:F
Credentials:BSCIPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9299 MONONGAHELA TRL
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-3389
Mailing Address - Country:US
Mailing Address - Phone:804-828-9952
Mailing Address - Fax:
Practice Address - Street 1:1300 W MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-3025
Practice Address - Country:US
Practice Address - Phone:804-828-9952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005065183500000X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No183500000XPharmacy Service ProvidersPharmacist