Provider Demographics
NPI:1457735177
Name:LAFFERTY, LYNNE
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:LAFFERTY
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 1:8 FIELDCREST DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2730
Mailing Address - Country:US
Mailing Address - Phone:610-831-2288
Mailing Address - Fax:
Practice Address - Street 1:2550 EISENHOWER AVE
Practice Address - Street 2:BUILDING B
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-2331
Practice Address - Country:US
Practice Address - Phone:484-690-0160
Practice Address - Fax:484-690-0165
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP037572L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist