Provider Demographics
NPI:1639462245
Name:MANFREDI, LORRAINE ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:ANN
Last Name:MANFREDI
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 1:42 WOODSONG DR
Mailing Address - Street 2:
Mailing Address - City:NORTH SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1840
Mailing Address - Country:US
Mailing Address - Phone:401-647-3745
Mailing Address - Fax:
Practice Address - Street 1:47 VILLAGE PLAZA WAY
Practice Address - Street 2:
Practice Address - City:NORTH SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1849
Practice Address - Country:US
Practice Address - Phone:401-934-2480
Practice Address - Fax:401-934-2970
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI22071835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist