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General NPI Number Information
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NPI Number | 1043587843
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Entity Type | Individual
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Provider Name | SHEIREN FARAG-EL-MASSAH PHARM.D., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/22/2011
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Last Update Date | 11/22/2011
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Provider Practice Location Address
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Address Line | 6525 UNIVERSITY AVE NE WALGREENS PHARMACY
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City | FRIDLEY
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State | MN
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Zip | 55432
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Country | US
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Telephone | 763-586-0730
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Fax |
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Provider Business Mailing Address
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Address Line | 10105 INDIGO DR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55347-1211
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Country | US
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Telephone | 952-446-5162
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 119883
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License Number State | MN
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