Provider Demographics
NPI:1780907626
Name:SANFILIPPO, CATHLEEN RENEE (RPH, ND)
Entity type:Individual
Prefix:MRS
First Name:CATHLEEN
Middle Name:RENEE
Last Name:SANFILIPPO
Suffix:
Gender:F
Credentials:RPH, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7155
Mailing Address - Country:US
Mailing Address - Phone:631-242-4651
Mailing Address - Fax:
Practice Address - Street 1:41 SCOTT ST
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-7155
Practice Address - Country:US
Practice Address - Phone:631-242-4651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-06
Last Update Date:2010-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042155-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist