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General NPI Number Information
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NPI Number | 1942465927
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Entity Type | Individual
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Provider Name | SHARI DENISE DEGRAW RN, RPH
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Gender | Female
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 424 S MAIN ST
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City | ELMIRA
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State | NY
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Zip | 14904-1314
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Country | US
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Telephone | 607-426-8829
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Fax |
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Provider Business Mailing Address
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Address Line | 267 BREESPORT RD
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City | HORSEHEADS
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State | NY
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Zip | 14845-9323
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Country | US
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Telephone | 607-426-8829
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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 | 041194
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License Number State | NY
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