Provider Demographics
NPI:1962539676
Name:MEZEIVTCH, LORI ANNE (RPH)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANNE
Last Name:MEZEIVTCH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4962 CARLYN DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-1944
Mailing Address - Country:US
Mailing Address - Phone:412-885-0460
Mailing Address - Fax:412-647-7951
Practice Address - Street 1:3601 5TH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3403
Practice Address - Country:US
Practice Address - Phone:412-647-3244
Practice Address - Fax:412-647-7951
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040921L1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy