Provider Demographics
NPI:1699503615
Name:SANGRIU, ELISA KATHRYN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ELISA
Middle Name:KATHRYN
Last Name:SANGRIU
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 1:4000 GARDEN CITY DR DEPT 6TH
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2418
Mailing Address - Country:US
Mailing Address - Phone:571-654-0006
Mailing Address - Fax:
Practice Address - Street 1:4000 GARDEN CITY DR DEPT 6TH
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2418
Practice Address - Country:US
Practice Address - Phone:571-654-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202222259183500000X
MD29897183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist