Provider Demographics
NPI:1285994608
Name:SHOKRIAN, HALLE (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:HALLE
Middle Name:
Last Name:SHOKRIAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MRS
Other - First Name:HALLE
Other - Middle Name:
Other - Last Name:MASLAVI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:11 MITCHELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024
Mailing Address - Country:US
Mailing Address - Phone:516-466-6445
Mailing Address - Fax:718-261-2114
Practice Address - Street 1:172-17 JAMAICA AVENUE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:516-382-3145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist