Provider Demographics
NPI:1154761112
Name:ZRENDA, LAURIE ANN (RPH)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:ZRENDA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:Z
Other - Last Name:PRIVETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:252 N BRIDE BROOK RD
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1410
Mailing Address - Country:US
Mailing Address - Phone:860-739-8363
Mailing Address - Fax:860-848-9974
Practice Address - Street 1:601 ROUTE 32
Practice Address - Street 2:
Practice Address - City:UNCASVILLE
Practice Address - State:CT
Practice Address - Zip Code:06382-2104
Practice Address - Country:US
Practice Address - Phone:860-848-7979
Practice Address - Fax:860-848-9997
Is Sole Proprietor?:No
Enumeration Date:2013-07-04
Last Update Date:2013-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist