Provider Demographics
NPI:1750879243
Name:RICHMOND, SHOSHANA Y (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHOSHANA
Middle Name:Y
Last Name:RICHMOND
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 1:1 SCHETTIG CT
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-2233
Mailing Address - Country:US
Mailing Address - Phone:845-425-2042
Mailing Address - Fax:
Practice Address - Street 1:382 ROUTE 59
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10952-3419
Practice Address - Country:US
Practice Address - Phone:845-368-2273
Practice Address - Fax:845-368-8124
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03715300183500000X
IL051.297099183500000X
NY063817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist