Provider Demographics
NPI:1508895731
Name:SZUMITA, LISA B (PHARMD, CDE)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:B
Last Name:SZUMITA
Suffix:
Gender:F
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:B
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:68 EVERETT DR
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-1156
Mailing Address - Country:US
Mailing Address - Phone:508-828-9739
Mailing Address - Fax:
Practice Address - Street 1:148 W RIVER ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2615
Practice Address - Country:US
Practice Address - Phone:401-770-4846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI3715183500000X
MA22416183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist