Provider Demographics
NPI:1144774225
Name:PISANO, SORANA GABRIELA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SORANA
Middle Name:GABRIELA
Last Name:PISANO
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 1:5585 TWIN KNOLLS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3245
Mailing Address - Country:US
Mailing Address - Phone:410-730-2789
Mailing Address - Fax:
Practice Address - Street 1:5585 TWIN KNOLLS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3245
Practice Address - Country:US
Practice Address - Phone:410-730-2789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-07
Last Update Date:2016-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist