Provider Demographics
NPI:1346515160
Name:SAGI, PRAVEENA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PRAVEENA
Middle Name:
Last Name:SAGI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 MERCURY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-5215
Mailing Address - Country:US
Mailing Address - Phone:717-918-4878
Mailing Address - Fax:
Practice Address - Street 1:402 MERCURY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-5215
Practice Address - Country:US
Practice Address - Phone:717-918-4878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist