Provider Demographics
NPI:1285702118
Name:TREACY, SABRINA MARIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:MARIE
Last Name:TREACY
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 1:99 WINDING RD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-3255
Mailing Address - Country:US
Mailing Address - Phone:516-390-9241
Mailing Address - Fax:
Practice Address - Street 1:1660 WALT WHITMAN RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4159
Practice Address - Country:US
Practice Address - Phone:800-218-5604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist