Healthcare Provider Details

I. General information

NPI: 1629859939
Provider Name (Legal Business Name): SABRINA MICHELLE MARQUEZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 MANCHESTER RD
GLASTONBURY CT
06033-1824
US

IV. Provider business mailing address

2329 JAMES ST
SYRACUSE NY
13206-3070
US

V. Phone/Fax

Practice location:
  • Phone: 860-781-7073
  • Fax: 860-781-7079
Mailing address:
  • Phone: 315-437-0893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number070988
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: