Provider Demographics
NPI:1063945780
Name:TEAL-CANTY, SHAYLYNN (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:SHAYLYNN
Middle Name:
Last Name:TEAL-CANTY
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:SHAY
Other - Middle Name:
Other - Last Name:CANTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:58 BRYCES CT
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-1676
Mailing Address - Country:US
Mailing Address - Phone:267-253-3313
Mailing Address - Fax:
Practice Address - Street 1:9 LANDIS AVE
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-4315
Practice Address - Country:US
Practice Address - Phone:856-451-4169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2023-04-03
Deactivation Date:2017-04-19
Deactivation Code:
Reactivation Date:2023-04-03
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03160600183500000X
PARP442093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist