Provider Demographics
NPI:1275254351
Name:LORA, EBONY S (CPCT/A PHLEBOTOMIST)
Entity Type:Individual
Prefix:MS
First Name:EBONY
Middle Name:S
Last Name:LORA
Suffix:
Gender:F
Credentials:CPCT/A PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TOBYHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18466-3616
Mailing Address - Country:US
Mailing Address - Phone:347-851-9037
Mailing Address - Fax:
Practice Address - Street 1:1028 KNOLLWOOD DR
Practice Address - Street 2:
Practice Address - City:TOBYHANNA
Practice Address - State:PA
Practice Address - Zip Code:18466-3616
Practice Address - Country:US
Practice Address - Phone:347-851-9037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty