Provider Demographics
NPI:1902153588
Name:LUCARELLI, GABRIELLA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:MARIE
Last Name:LUCARELLI
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 1:1122 W BRICKHAVEN CV
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-9299
Mailing Address - Country:US
Mailing Address - Phone:570-954-0794
Mailing Address - Fax:
Practice Address - Street 1:4502 SHIPYARD BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6163
Practice Address - Country:US
Practice Address - Phone:910-799-3162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist