Provider Demographics
NPI:1710089727
Name:NOZZI, LORI SUSAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:SUSAN
Last Name:NOZZI
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 1:631 TERRACE ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-3150
Mailing Address - Country:US
Mailing Address - Phone:570-346-2009
Mailing Address - Fax:
Practice Address - Street 1:700 QUINCY AVE
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1724
Practice Address - Country:US
Practice Address - Phone:570-340-2264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039878L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist