Provider Demographics
NPI:1750773610
Name:SHEN, EDUARDO (PHARMD)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:SHEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125-133 3RD AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-529-7140
Mailing Address - Fax:
Practice Address - Street 1:125-133 3RD AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2543
Practice Address - Country:US
Practice Address - Phone:212-529-7140
Practice Address - Fax:212-529-7145
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060203-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist