Provider Demographics
NPI:1467048546
Name:DESMARAIS, SARA JESSICA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:JESSICA
Last Name:DESMARAIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:JESSICA
Other - Last Name:BRENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9 MAID MARION DR
Mailing Address - Street 2:
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335-1308
Mailing Address - Country:US
Mailing Address - Phone:609-346-6749
Mailing Address - Fax:
Practice Address - Street 1:634 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-6007
Practice Address - Country:US
Practice Address - Phone:860-859-9758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05153183500000X
CTPCT.0012403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist