Provider Demographics
NPI:1932114683
Name:LUGO, LORRAINE (RPH)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:LUGO
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 1:78 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-1975
Mailing Address - Country:US
Mailing Address - Phone:908-647-0180
Mailing Address - Fax:908-604-5359
Practice Address - Street 1:151 KNOLLCROFT RD
Practice Address - Street 2:PHARMACY SERVICE (119-LY)
Practice Address - City:LYONS
Practice Address - State:NJ
Practice Address - Zip Code:07939-5001
Practice Address - Country:US
Practice Address - Phone:908-647-0180
Practice Address - Fax:908-604-5359
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01616100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist