Healthcare Provider Details

I. General information

NPI: 1245836519
Provider Name (Legal Business Name): JOSEPH EDWARD LEONE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2020
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 ROUTE 70
MANCHESTER NJ
08759-5804
US

IV. Provider business mailing address

611 WESTON DR
TOMS RIVER NJ
08755-3249
US

V. Phone/Fax

Practice location:
  • Phone: 732-657-0099
  • Fax: 732-657-0033
Mailing address:
  • Phone: 732-286-1448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI01634900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: