Provider Demographics
NPI:1962687962
Name:SHULTZ, SARAH L (RPH)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:SHULTZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-5021
Mailing Address - Country:US
Mailing Address - Phone:518-456-2803
Mailing Address - Fax:518-452-4336
Practice Address - Street 1:2025 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5021
Practice Address - Country:US
Practice Address - Phone:518-456-5112
Practice Address - Fax:518-869-7214
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist