Healthcare Provider Details

I. General information

NPI: 1942429329
Provider Name (Legal Business Name): JOSEPH MICHAEL CESTA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6175 HI-TEK COURT
MASON OH
45040
US

IV. Provider business mailing address

2494 MANISTIQUE LAKES DRIVE
LEBANON OH
45036
US

V. Phone/Fax

Practice location:
  • Phone: 513-459-8484
  • Fax: 513-459-8606
Mailing address:
  • Phone: 513-383-4290
  • Fax: 513-459-8606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number03-3-14175
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: