Provider Demographics
NPI:1427472414
Name:SADRATI, JOANNE M (RPH)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:M
Last Name:SADRATI
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 1:33 WAVE AVE
Mailing Address - Street 2:APT3
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-5452
Mailing Address - Country:US
Mailing Address - Phone:508-863-9184
Mailing Address - Fax:
Practice Address - Street 1:33 WAVE AVE
Practice Address - Street 2:APT3
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-5452
Practice Address - Country:US
Practice Address - Phone:508-863-9184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH20276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist