Individual provider Active NPI

Savanna Dicristina, PHARMD, MPH, BCPS

  • Pharmacist
  • Brockton, MA
National Provider Identifier
1124805221
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH997232 Issued in MA
Practice address
479 Torrey St
Brockton, MA 02301-4617
Phone
(617) 373-6365
NPI assigned
Sep 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH997232 MA Primary

Addresses

Primary practice location

479 Torrey St
Brockton, MA 02301-4617

Mailing address

4 Avalon Dr Unit 4419
Quincy, MA 02169-4246
Phone (609) 477-0565

Other names 1

  • Savanna San Filippo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH997232MAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1124805221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 AVALON DR UNIT 4419",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694246",
            "telephone_number": "609-477-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014617",
            "telephone_number": "617-373-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICRISTINA",
        "first_name": "SAVANNA",
        "credential": "PHARMD, MPH, BCPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH997232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAVANNA",
            "last_name": "SAN FILIPPO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.