Provider Demographics
NPI:1154876951
Name:PALMISCIANO, LAUREN NICOLE (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:PALMISCIANO
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 JACKSONIA DR
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-1411
Mailing Address - Country:US
Mailing Address - Phone:401-598-6578
Mailing Address - Fax:
Practice Address - Street 1:55 JACKSONIA DR
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-1411
Practice Address - Country:US
Practice Address - Phone:401-598-6578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist