Provider Demographics
NPI:1497201784
Name:SANNA, ALEXA TAYLOR (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:TAYLOR
Last Name:SANNA
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 1:8510 16TH ST
Mailing Address - Street 2:APARTMENT 719
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-5950
Mailing Address - Country:US
Mailing Address - Phone:203-376-9536
Mailing Address - Fax:
Practice Address - Street 1:5657 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1412
Practice Address - Country:US
Practice Address - Phone:410-788-1207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist