Provider Demographics
NPI:1588988786
Name:SHEELEY, MARYANN E (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARYANN
Middle Name:E
Last Name:SHEELEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3832
Mailing Address - Country:US
Mailing Address - Phone:845-338-8000
Mailing Address - Fax:845-338-5128
Practice Address - Street 1:86 N FRONT ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3832
Practice Address - Country:US
Practice Address - Phone:845-338-8000
Practice Address - Fax:845-338-5128
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027580-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist