Provider Demographics
NPI:1144535352
Name:SANDI, LAWRENCE A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:A
Last Name:SANDI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 OHIO ST APT 45
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3198
Mailing Address - Country:US
Mailing Address - Phone:617-230-4625
Mailing Address - Fax:207-876-2721
Practice Address - Street 1:682 OHIO ST APT 45
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3198
Practice Address - Country:US
Practice Address - Phone:617-230-4625
Practice Address - Fax:207-876-2721
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist