Provider Demographics
NPI:1912176942
Name:IGNAZIO, SARAH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:IGNAZIO
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 1:5 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-4067
Mailing Address - Country:US
Mailing Address - Phone:518-792-4302
Mailing Address - Fax:518-792-2217
Practice Address - Street 1:5 MAIN ST
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-4067
Practice Address - Country:US
Practice Address - Phone:518-792-4302
Practice Address - Fax:518-792-2217
Is Sole Proprietor?:No
Enumeration Date:2008-02-24
Last Update Date:2008-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist