Provider Demographics
NPI:1356761225
Name:MASHNI, ESSA ELIAS (RPH)
Entity type:Individual
Prefix:
First Name:ESSA
Middle Name:ELIAS
Last Name:MASHNI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45624 ELMWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2462
Mailing Address - Country:US
Mailing Address - Phone:734-788-8409
Mailing Address - Fax:
Practice Address - Street 1:45624 ELMWOOD CIR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-2462
Practice Address - Country:US
Practice Address - Phone:734-788-8409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027105183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist