Provider Demographics
NPI:1467575308
Name:LANZILLO, DANTE (RPH,CDM)
Entity Type:Individual
Prefix:
First Name:DANTE
Middle Name:
Last Name:LANZILLO
Suffix:
Gender:M
Credentials:RPH,CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SHEFFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3996
Mailing Address - Country:US
Mailing Address - Phone:603-886-3638
Mailing Address - Fax:
Practice Address - Street 1:212 LOWELL RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4928
Practice Address - Country:US
Practice Address - Phone:603-880-1744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR1752183500000X
MA23792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist