Provider Demographics
NPI:1427527191
Name:SHAH, SHERRELL P (PHARM D)
Entity type:Individual
Prefix:
First Name:SHERRELL
Middle Name:P
Last Name:SHAH
Suffix:
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 1:188 REBECCA PARK
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1833
Mailing Address - Country:US
Mailing Address - Phone:718-581-4099
Mailing Address - Fax:
Practice Address - Street 1:184 BARTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-1573
Practice Address - Country:US
Practice Address - Phone:716-881-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-25
Last Update Date:2018-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064594183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist