Provider Demographics
NPI:1710203575
Name:WUNDER, LAURENE L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LAURENE
Middle Name:L
Last Name:WUNDER
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 1:1 TEAL DR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-8233
Mailing Address - Country:US
Mailing Address - Phone:215-702-8292
Mailing Address - Fax:
Practice Address - Street 1:696 STONY HILL RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-4419
Practice Address - Country:US
Practice Address - Phone:215-321-9143
Practice Address - Fax:215-321-3017
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032175L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist