Provider Demographics
NPI:1942755939
Name:DORAZIO, KATLYN (PHARMD)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:DORAZIO
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 1:1446 PARKVIEW CIR UNIT 203
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-4340
Mailing Address - Country:US
Mailing Address - Phone:724-809-3111
Mailing Address - Fax:
Practice Address - Street 1:1019 GRANDIFLORA DR
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-7453
Practice Address - Country:US
Practice Address - Phone:910-371-0233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist