Healthcare Provider Details

I. General information

NPI: 1881875797
Provider Name (Legal Business Name): SHELDON PIEKNY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2007
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 MAIN ST
PEEKSKILL NY
10566-2907
US

IV. Provider business mailing address

1107 MAIN ST
PEEKSKILL NY
10566-2907
US

V. Phone/Fax

Practice location:
  • Phone: 914-737-0154
  • Fax: 914-788-7037
Mailing address:
  • Phone: 914-737-0154
  • Fax: 914-788-7037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32682
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: