1871772343 NPI number — DR. SHARAIL SMITH LAWRENCE PHARMD

Table of content: DR. SHARAIL SMITH LAWRENCE PHARMD (NPI 1871772343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871772343 NPI number — DR. SHARAIL SMITH LAWRENCE PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAWRENCE
Provider First Name:
SHARAIL
Provider Middle Name:
SMITH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871772343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
46 NOB HILL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELMSFORD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10523-2417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-338-9119
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
626 SWIFT RD
Provider Second Line Business Practice Location Address:
2ND FLOOR - WARRIOR TRANSITION UNIT
Provider Business Practice Location Address City Name:
WEST POINT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10996-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
945-938-0269
Provider Business Practice Location Address Fax Number:
845-938-0286
Provider Enumeration Date:
10/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PS0037746 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 055320 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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