Provider Demographics
NPI:1689950271
Name:SARANITZKY, ELISA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:SARANITZKY
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 1:1471 WHALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1153
Mailing Address - Country:US
Mailing Address - Phone:203-389-2143
Mailing Address - Fax:203-389-7587
Practice Address - Street 1:1471 WHALLEY AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1153
Practice Address - Country:US
Practice Address - Phone:203-389-2143
Practice Address - Fax:203-389-7587
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0011137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist