Healthcare Provider Details

I. General information

NPI: 1710961339
Provider Name (Legal Business Name): ANGELA SHENFIELD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 CENTRAL AVE
CATSKILL NY
12414-1746
US

IV. Provider business mailing address

19 CENTRAL AVE
CATSKILL NY
12414-1746
US

V. Phone/Fax

Practice location:
  • Phone: 518-943-4182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17158
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20 055629
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: