Provider Demographics
NPI:1710793435
Name:WIENCZKOWSKI, SHAMIM CHAPARIAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHAMIM
Middle Name:CHAPARIAN
Last Name:WIENCZKOWSKI
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 1:4408 HAMMOCKS DR APT 208
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-7427
Mailing Address - Country:US
Mailing Address - Phone:202-344-0265
Mailing Address - Fax:
Practice Address - Street 1:4408 HAMMOCKS DR APT 208
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-7427
Practice Address - Country:US
Practice Address - Phone:202-344-0265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP459092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist