Provider Demographics
NPI:1437583432
Name:MASTROLIA, SARAH MEGAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MEGAN
Last Name:MASTROLIA
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 1:335 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2119
Mailing Address - Country:US
Mailing Address - Phone:315-525-6243
Mailing Address - Fax:
Practice Address - Street 1:335 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2119
Practice Address - Country:US
Practice Address - Phone:315-525-6243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist