Provider Demographics
NPI:1083428940
Name:SHAJI, JOSEPH (PHARMD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SHAJI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-9575
Mailing Address - Country:US
Mailing Address - Phone:215-512-4223
Mailing Address - Fax:
Practice Address - Street 1:4810 PENN AVE
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-8601
Practice Address - Country:US
Practice Address - Phone:610-670-9986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP459127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist