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General NPI Number Information
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NPI Number | 1164607123
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Entity Type | Individual
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Provider Name | RACHELLE SHAKERDGE R PH
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Gender | Female
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 79 MILL HILL RD
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City | WOODSTOCK
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State | NY
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Zip | 12498-1303
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Country | US
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Telephone | 845-679-2222
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Fax | 845-679-7658
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Provider Business Mailing Address
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Address Line | 2314 GLASCO TPKE
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City | WOODSTOCK
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State | NY
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Zip | 12498-1072
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Country | US
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Telephone | 845-679-1057
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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 | 034536
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License Number State | NY
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