Provider Demographics
NPI:1285289603
Name:CHARBONNEAU, MARIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:CHARBONNEAU
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 1:4 CROSSWYNDS DR
Mailing Address - Street 2:
Mailing Address - City:SAUNDERSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02874-2407
Mailing Address - Country:US
Mailing Address - Phone:491-644-9800
Mailing Address - Fax:
Practice Address - Street 1:1150 NEW LONDON AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-3036
Practice Address - Country:US
Practice Address - Phone:401-433-9277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH060211835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care