Sandra Elizabeth Colucci, PHARM.D

Individual provider Active NPI Pharmacist · Hanscom Afb, MA

NPI 1992190490 · NPPES record last updated Apr 1, 2015

Key facts

NPI
1992190490
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PH235481 (MA)
Practice address
90 Vandenberg Dr BLDG 1900
Hanscom Afb, MA 01731-2104
Phone
(781) 225-6173
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH235481MAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH235481 MA Yes

Addresses

Primary practice location

90 Vandenberg Dr BLDG 1900
Hanscom Afb, MA 01731-2104

Mailing address

90 Vandenberg Dr
Hanscom Afb
Hanscom Afb, MA 01731-2104

Other providers in Hanscom Afb, MA

All providers in Hanscom Afb, MA · Pharmacist in Massachusetts

Sources for this page

Verify at the official NPI Registry.