Provider Demographics
NPI:1922385632
Name:SHAROUPIM, ANN MARIE SAIED (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:SAIED
Last Name:SHAROUPIM
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 1:29 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2732
Mailing Address - Country:US
Mailing Address - Phone:201-920-4121
Mailing Address - Fax:
Practice Address - Street 1:29 WILSON AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2732
Practice Address - Country:US
Practice Address - Phone:201-920-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03443000183500000X
NY056201183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist