Healthcare Provider Details

I. General information

NPI: 1669106043
Provider Name (Legal Business Name): LORI RAMKISSOON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI MAINWARING PHD

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 07/12/2022
Certification Date: 07/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4220
US

IV. Provider business mailing address

5215 COFFEETREE DR
RALEIGH NC
27613-4553
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-1790
  • Fax:
Mailing address:
  • Phone: 202-494-1410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: