Provider Demographics
NPI:1770236549
Name:SHOFRAN, ALLISON ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:ELIZABETH
Last Name:SHOFRAN
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 1:127 CORCORAN ST
Mailing Address - Street 2:
Mailing Address - City:OLD FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:18518-1709
Mailing Address - Country:US
Mailing Address - Phone:610-417-7011
Mailing Address - Fax:
Practice Address - Street 1:300 CONSHOHOCKEN STATE RD STE 260
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-3820
Practice Address - Country:US
Practice Address - Phone:610-276-1318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66771183500000X
PARP455460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP455460OtherBOARD OF PHARMACY
TX66771OtherBOARD OF PHARMACY