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General NPI Number Information
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NPI Number | 1215259502
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Entity Type | Individual
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Provider Name | MARIANA SHAKHMUROV PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 02/27/2010
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Last Update Date | 02/27/2010
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Provider Practice Location Address
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Address Line | 4612 GREENPOINT AVE
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City | SUNNYSIDE
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State | NY
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Zip | 11104-1708
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Country | US
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Telephone | 718-570-6408
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Fax |
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Provider Business Mailing Address
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Address Line | 6307 SAUNDERS ST APT 2F
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City | REGO PARK
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State | NY
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Zip | 11374-2035
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Country | US
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Telephone | 718-570-6408
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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 | 052939
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License Number State | NY
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