Individual
ANDREW SHASANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4098 EDGMONT AVE, BROOKHAVEN, PA 19015-2211
(610) 876-8815
Mailing address
4098 EDGMONT AVE, BROOKHAVEN, PA 19015-2211
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP455097
PA
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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