Provider Demographics
NPI:1144823923
Name:SIDNEY, LAUREN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:SIDNEY
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 1:1032 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16635-7712
Mailing Address - Country:US
Mailing Address - Phone:814-695-2303
Mailing Address - Fax:
Practice Address - Street 1:2500 PLANK ROAD COMMONS
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-9327
Practice Address - Country:US
Practice Address - Phone:814-946-9784
Practice Address - Fax:814-946-3722
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP046381L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist