Provider Demographics
NPI:1811579675
Name:KAMENSKY, SANDRA JOAN (REGISTERED PHARMACIS)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:JOAN
Last Name:KAMENSKY
Suffix:
Gender:F
Credentials:REGISTERED PHARMACIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25019 DUFFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-3262
Mailing Address - Country:US
Mailing Address - Phone:440-715-5344
Mailing Address - Fax:
Practice Address - Street 1:34310 AURORA RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-3890
Practice Address - Country:US
Practice Address - Phone:440-519-1028
Practice Address - Fax:440-519-1382
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03319900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist