Provider Demographics
NPI:1396925400
Name:NICOLETTA, SHARI LYNN II (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:LYNN
Last Name:NICOLETTA
Suffix:II
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5615
Mailing Address - Country:US
Mailing Address - Phone:315-732-1499
Mailing Address - Fax:315-732-1703
Practice Address - Street 1:1917 GENESEE STREET
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5615
Practice Address - Country:US
Practice Address - Phone:315-732-1499
Practice Address - Fax:315-732-1703
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049243183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist