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General NPI Number Information
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NPI Number | 1205110079
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Entity Type | Individual
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Provider Name | JONATHAN LO PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 100 WOODS RD STE 1A02
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City | VALHALLA
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State | NY
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Zip | 10595-1530
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Country | US
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Telephone | 914-493-6337
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Fax |
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Provider Business Mailing Address
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Address Line | 100 WOODS RD # 1A02
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City | VALHALLA
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State | NY
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Zip | 10595-1530
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03149600
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License Number State | NJ
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