Provider Demographics
NPI:1720535826
Name:ELABSY, SHEIRIN
Entity Type:Individual
Prefix:
First Name:SHEIRIN
Middle Name:
Last Name:ELABSY
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 1:6010 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-7501
Mailing Address - Country:US
Mailing Address - Phone:502-526-7000
Mailing Address - Fax:
Practice Address - Street 1:6010 LAUREL LN
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-7501
Practice Address - Country:US
Practice Address - Phone:502-526-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY147481835P1200X
IN26021930A1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy