Provider Demographics
NPI:1104108893
Name:HAZELTON, LAUREN F (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:F
Last Name:HAZELTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 ARCH ST
Mailing Address - Street 2:UNIT 303
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-1800
Mailing Address - Country:US
Mailing Address - Phone:267-970-5930
Mailing Address - Fax:
Practice Address - Street 1:8 HADDON AVE
Practice Address - Street 2:
Practice Address - City:HADDON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08108-2706
Practice Address - Country:US
Practice Address - Phone:856-869-7504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02841400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist