Provider Demographics
NPI:1891391694
Name:ARCANGEL, LORENZ LEOMAR LARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LORENZ LEOMAR
Middle Name:LARA
Last Name:ARCANGEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 WATERTOWN ST
Mailing Address - Street 2:
Mailing Address - City:WEST NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-2130
Mailing Address - Country:US
Mailing Address - Phone:617-964-7736
Mailing Address - Fax:
Practice Address - Street 1:999 WATERTOWN ST
Practice Address - Street 2:
Practice Address - City:WEST NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2130
Practice Address - Country:US
Practice Address - Phone:617-964-7736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236755183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist