Provider Demographics
NPI:1780293449
Name:SARRANTONIO, ASHLEY NICOLE (RPH)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:SARRANTONIO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 KNOB HILL DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-2117
Mailing Address - Country:US
Mailing Address - Phone:516-591-4328
Mailing Address - Fax:
Practice Address - Street 1:2412 KNOB HILL DR
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-2117
Practice Address - Country:US
Practice Address - Phone:516-591-4328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037546183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist