Provider Demographics
NPI:1639694946
Name:SANBORN, CHRISTINA ROBYN
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ROBYN
Last Name:SANBORN
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 1:12 SHEFFIELD MANOR CT APT 302
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7760
Mailing Address - Country:US
Mailing Address - Phone:315-576-6175
Mailing Address - Fax:
Practice Address - Street 1:320 DOMER AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4804
Practice Address - Country:US
Practice Address - Phone:301-776-7514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist