Provider Demographics
NPI:1356912570
Name:BRAZZO, PAUL EUGENE (RPH)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:EUGENE
Last Name:BRAZZO
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 1:721 DORSET RD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-3385
Mailing Address - Country:US
Mailing Address - Phone:610-530-2250
Mailing Address - Fax:
Practice Address - Street 1:6465 VILLAGE LN STE 9
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-8474
Practice Address - Country:US
Practice Address - Phone:610-421-8200
Practice Address - Fax:610-421-8400
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032241L1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist