Provider Demographics
NPI:1518273630
Name:LAVELLA, PATRICK FRANCIS (R PH)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:FRANCIS
Last Name:LAVELLA
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 HARDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VENETIA
Mailing Address - State:PA
Mailing Address - Zip Code:15367-2318
Mailing Address - Country:US
Mailing Address - Phone:412-427-4948
Mailing Address - Fax:724-731-0164
Practice Address - Street 1:114 HARDWOOD DR
Practice Address - Street 2:
Practice Address - City:VENETIA
Practice Address - State:PA
Practice Address - Zip Code:15367-2318
Practice Address - Country:US
Practice Address - Phone:412-427-4948
Practice Address - Fax:724-731-0164
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034181L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist