Provider Demographics
NPI:1043532534
Name:PATRIZIO, LELIO (RPH)
Entity type:Individual
Prefix:
First Name:LELIO
Middle Name:
Last Name:PATRIZIO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-1140
Mailing Address - Country:US
Mailing Address - Phone:914-925-5551
Mailing Address - Fax:914-925-5113
Practice Address - Street 1:275 NORTH ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1140
Practice Address - Country:US
Practice Address - Phone:914-925-5551
Practice Address - Fax:914-925-5113
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist