Provider Demographics
NPI:1891404828
Name:MASTRONARDI, SABRINA LAUREN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:LAUREN
Last Name:MASTRONARDI
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 1:527 W LAFAYETTE BLVD APT 15E
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-3194
Mailing Address - Country:US
Mailing Address - Phone:248-574-2860
Mailing Address - Fax:
Practice Address - Street 1:29030 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1010
Practice Address - Country:US
Practice Address - Phone:248-356-1757
Practice Address - Fax:248-356-1857
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist