Provider Demographics
NPI:1477763167
Name:MAROTTA, SANDRA E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:E
Last Name:MAROTTA
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 1:8 MANZONI FARM RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-1966
Mailing Address - Country:US
Mailing Address - Phone:203-867-5480
Mailing Address - Fax:203-867-5511
Practice Address - Street 1:8 MANZONI FARM RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-1966
Practice Address - Country:US
Practice Address - Phone:203-867-5480
Practice Address - Fax:203-867-5511
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist