Provider Demographics
NPI:1750592465
Name:OSTONAL, LOLITA OGOY (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:LOLITA
Middle Name:OGOY
Last Name:OSTONAL
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 LIGHT HORSE LOOP
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-2250
Mailing Address - Country:US
Mailing Address - Phone:757-368-9029
Mailing Address - Fax:
Practice Address - Street 1:3533 LIGHT HORSE LOOP
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-2250
Practice Address - Country:US
Practice Address - Phone:757-368-9029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002050130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist