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General NPI Number Information
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NPI Number | 1104422054
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Entity Type | Individual
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Provider Name | HALIE RAE SHEEHAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 2601 SHERIDAN DR
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City | TONAWANDA
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State | NY
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Zip | 14150-9413
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Country | US
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Telephone | 716-835-3348
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Fax |
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Provider Business Mailing Address
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Address Line | 256 WASHINGTON AVE LOWR
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City | KENMORE
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State | NY
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Zip | 14217-1805
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Country | US
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Telephone | 716-471-9050
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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 | 067445
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License Number State | NY
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