Provider Demographics
NPI:1285498238
Name:BUFALINI, SHAJAL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHAJAL
Middle Name:
Last Name:BUFALINI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 PINE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-8961
Mailing Address - Country:US
Mailing Address - Phone:734-660-2889
Mailing Address - Fax:
Practice Address - Street 1:5320 ELLIOTT DR # 202
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1032
Practice Address - Country:US
Practice Address - Phone:734-712-2227
Practice Address - Fax:734-712-0229
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53151193731835P0018X, 1835P2201X, 183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy