Provider Demographics
NPI:1821301789
Name:JOSEPH, SHINY SHAJI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHINY
Middle Name:SHAJI
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:SHINY
Other - Middle Name:
Other - Last Name:SHAJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2503 WELSH RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-3203
Mailing Address - Country:US
Mailing Address - Phone:215-671-0544
Mailing Address - Fax:
Practice Address - Street 1:2503 WELSH RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-3203
Practice Address - Country:US
Practice Address - Phone:215-671-0544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440581183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist