Provider Demographics
NPI:1932510740
Name:DHAMSANIA, SHAVINEE JAY
Entity Type:Individual
Prefix:MRS
First Name:SHAVINEE
Middle Name:JAY
Last Name:DHAMSANIA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHAVINEE
Other - Middle Name:RAJESH
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:185 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5522
Mailing Address - Country:US
Mailing Address - Phone:781-321-1765
Mailing Address - Fax:
Practice Address - Street 1:185 CENTRE ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5522
Practice Address - Country:US
Practice Address - Phone:781-321-1765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH235131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist