Healthcare Provider Details

I. General information

NPI: 1962539676
Provider Name (Legal Business Name): LORI ANNE MEZEIVTCH RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 5TH AVE
PITTSBURGH PA
15213-3403
US

IV. Provider business mailing address

4962 CARLYN DR
PITTSBURGH PA
15236-1944
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-3244
  • Fax: 412-647-7951
Mailing address:
  • Phone: 412-885-0460
  • Fax: 412-647-7951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRP040921L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: