Provider Demographics
NPI:1154333557
Name:PANSARELLA, SALVATORE ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:SALVATORE
Middle Name:ANTHONY
Last Name:PANSARELLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 AMANDA CT
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-2418
Mailing Address - Country:US
Mailing Address - Phone:914-347-4785
Mailing Address - Fax:914-347-4136
Practice Address - Street 1:2 AMANDA CT
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-2418
Practice Address - Country:US
Practice Address - Phone:914-347-4785
Practice Address - Fax:914-347-4136
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist