Healthcare Provider Details

I. General information

NPI: 1285064683
Provider Name (Legal Business Name): SHAINA ELIZABETH DALEY PHARM.D. R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2013
Last Update Date: 11/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W MANLIUS ST
EAST SYRACUSE NY
13057-2547
US

IV. Provider business mailing address

300 W MANLIUS ST
EAST SYRACUSE NY
13057-2547
US

V. Phone/Fax

Practice location:
  • Phone: 315-434-9178
  • Fax:
Mailing address:
  • Phone: 315-434-9178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI057772
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number234422
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: