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NPI Code Detail

MEDICARE: DANIEL SHAN PHARM.D.

MEDICARE: DANIEL SHAN PHARM.D.
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
1183500000XPharmacist7331CT

General Provider Information

NPI Number : 1952667602
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL SHAN PHARM.D.
Provider Business Mailing Address
First Line : 118 LANCASTER WAY
Second Line :
City : CHESHIRE
State : CT
Zip : 06410-1526
Country : US
Telephone Number : 203-272-7710
Fax Number :
Provider Business Practice Location Address
First Line : 370 BASSETT RD
Second Line :
City : NORTH HAVEN
State : CT
Zip : 06473-4201
Country : US
Telephone Number : 203-234-5492
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2012
Last Update Date : 04/06/2012

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