Provider Demographics
NPI:1326694324
Name:DIPIERRO, SADIE
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:
Last Name:DIPIERRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MELROSE ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8535
Mailing Address - Country:US
Mailing Address - Phone:207-653-4926
Mailing Address - Fax:
Practice Address - Street 1:1036 POST RD
Practice Address - Street 2:
Practice Address - City:WELLS
Practice Address - State:ME
Practice Address - Zip Code:04090-4500
Practice Address - Country:US
Practice Address - Phone:207-646-6894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH238948183500000X
MEPR69302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist