Healthcare Provider Details

I. General information

NPI: 1982509253
Provider Name (Legal Business Name): JOSEPH DEDONA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 VILLAGE AT STONES CROSSING RD
EASTON PA
18045-5085
US

IV. Provider business mailing address

4016 LANTERN PL W
EASTON PA
18045-6128
US

V. Phone/Fax

Practice location:
  • Phone: 855-795-2440
  • Fax:
Mailing address:
  • Phone: 646-200-1773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP438875
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: