Provider Demographics
NPI:1023613080
Name:MAGLIETTA, LAURIE CHRISTINE
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:CHRISTINE
Last Name:MAGLIETTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SHOPPING PLZ
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-3022
Mailing Address - Country:US
Mailing Address - Phone:440-247-8132
Mailing Address - Fax:440-247-0669
Practice Address - Street 1:34 SHOPPING PLZ
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-3022
Practice Address - Country:US
Practice Address - Phone:440-247-8132
Practice Address - Fax:440-247-0669
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03122689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist