Provider Demographics
NPI:1447322300
Name:SPOSATO, ROBERTA W (RPH)
Entity type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:W
Last Name:SPOSATO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:ROBERTA
Other - Middle Name:
Other - Last Name:WOODLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:18 BROOKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891
Mailing Address - Country:US
Mailing Address - Phone:401-596-4320
Mailing Address - Fax:401-596-4320
Practice Address - Street 1:25 WELLS ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891
Practice Address - Country:US
Practice Address - Phone:401-348-3450
Practice Address - Fax:401-348-3632
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12619183500000X
RI4343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist