Provider Demographics
NPI:1376285171
Name:RAMOS-LAZO, PATRICIA (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:RAMOS-LAZO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GOVE ST
Mailing Address - Street 2:
Mailing Address - City:EAST BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-1931
Mailing Address - Country:US
Mailing Address - Phone:617-568-4000
Mailing Address - Fax:617-568-4572
Practice Address - Street 1:10 GOVE ST
Practice Address - Street 2:ATTN: PHARMACY
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-1931
Practice Address - Country:US
Practice Address - Phone:617-568-4000
Practice Address - Fax:617-568-4572
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist