Provider Demographics
NPI:1194047936
Name:SHAFIR, INNA
Entity type:Individual
Prefix:MRS
First Name:INNA
Middle Name:
Last Name:SHAFIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13-38 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1813
Mailing Address - Country:US
Mailing Address - Phone:201-797-6888
Mailing Address - Fax:201-797-5497
Practice Address - Street 1:13-38 RIVER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1813
Practice Address - Country:US
Practice Address - Phone:201-797-6888
Practice Address - Fax:201-797-5497
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02441800183500000X
NY041543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist