Provider Demographics
NPI:1467593954
Name:CRUDI, LORI A (PHARMD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:CRUDI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 LOCUST AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6148
Mailing Address - Country:US
Mailing Address - Phone:203-792-2044
Mailing Address - Fax:203-778-8672
Practice Address - Street 1:95 LOCUST AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6148
Practice Address - Country:US
Practice Address - Phone:203-792-2044
Practice Address - Fax:203-778-8672
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT10312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist