Provider Demographics
NPI:1215390190
Name:SHAROYAN, ARTHUR
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:SHAROYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 ARAMINGO AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19137-1001
Mailing Address - Country:US
Mailing Address - Phone:215-288-2828
Mailing Address - Fax:
Practice Address - Street 1:3745 ARAMINGO AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19137
Practice Address - Country:US
Practice Address - Phone:215-288-2828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001789538Medicaid