MEDICARE: POLINA SHMURAK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI03237900	NJ

General Provider Information

NPI Number	:	1417322389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POLINA SHMURAK

Provider Business Mailing Address
First Line	:	124 PAWNEE RD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1146
Country	:	US
Telephone Number	:	732-363-0033
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 ROUTE 37 E
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-5375
Country	:	US
Telephone Number	:	732-341-0022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2015
Last Update Date	:	12/03/2015

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Directions to “ POLINA SHMURAK ” Practice Location

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