Provider Demographics
NPI:1881917094
Name:FARRELL, SHARON ANN (RPH)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:FARRELL
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 1:385 LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-2328
Mailing Address - Country:US
Mailing Address - Phone:518-884-8021
Mailing Address - Fax:
Practice Address - Street 1:839 ROUTE 146
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3861
Practice Address - Country:US
Practice Address - Phone:518-373-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039588-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist