Healthcare Provider Details

I. General information

NPI: 1760771059
Provider Name (Legal Business Name): JOSEPH W MALINOSKI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 MAIN ST
MONSON MA
01057-1320
US

IV. Provider business mailing address

117 MAIN ST
MONSON MA
01057-1320
US

V. Phone/Fax

Practice location:
  • Phone: 413-267-4021
  • Fax: 413-267-4051
Mailing address:
  • Phone: 413-267-4021
  • Fax: 413-267-4051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22266
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4985
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: