Provider Demographics
NPI:1922460468
Name:DATTI, ROSANA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROSANA
Middle Name:
Last Name:DATTI
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 1:633 LAKE ARTESIA LN
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-9561
Mailing Address - Country:US
Mailing Address - Phone:919-606-9156
Mailing Address - Fax:
Practice Address - Street 1:805 TOWN CENTRE BLVD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2179
Practice Address - Country:US
Practice Address - Phone:919-606-9156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist