Provider Demographics
NPI:1972992949
Name:SHAMS, TALI (PHARMD)
Entity Type:Individual
Prefix:
First Name:TALI
Middle Name:
Last Name:SHAMS
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 1:360 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8437
Mailing Address - Country:US
Mailing Address - Phone:212-375-9401
Mailing Address - Fax:
Practice Address - Street 1:360 6TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8437
Practice Address - Country:US
Practice Address - Phone:212-375-9401
Practice Address - Fax:212-375-9406
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-14
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72202183500000X
NY065123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist