Basic Information
Provider Information
NPI: 1851531842
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAZURI
FirstName: PATRICIA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PSYD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HAMMOND
OtherFirstName: PATRICIA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2817 REILLY RD
Address2: WOMACK ARMY MEDICAL CENTER
City: FORT BRAGG
State: NC
PostalCode: 28310
CountryCode: US
TelephoneNumber: 9109078922
FaxNumber: 9109076069
Practice Location
Address1: 9040 JACKSON AVE
Address2: MADIGAN ARMY MEDICAL CENTER
City: TACOMA
State: WA
PostalCode: 98431
CountryCode: US
TelephoneNumber: 2534772546
FaxNumber: 9109076069
Other Information
ProviderEnumerationDate: 03/03/2009
LastUpdateDate: 09/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPY60065054WAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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