Provider Demographics
NPI:1124805221
Name:DICRISTINA, SAVANNA (PHARMD, MPH, BCPS)
Entity type:Individual
Prefix:
First Name:SAVANNA
Middle Name:
Last Name:DICRISTINA
Suffix:
Gender:F
Credentials:PHARMD, MPH, BCPS
Other - Prefix:
Other - First Name:SAVANNA
Other - Middle Name:
Other - Last Name:SAN FILIPPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 AVALON DR UNIT 4419
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4246
Mailing Address - Country:US
Mailing Address - Phone:609-477-0565
Mailing Address - Fax:
Practice Address - Street 1:479 TORREY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4617
Practice Address - Country:US
Practice Address - Phone:617-373-6365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH997232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist