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General NPI Number Information
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NPI Number | 1316745961
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Entity Type | Individual
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Provider Name | JOSEPH WEZENTER
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Gender |
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 255 W SPRING VALLEY AVE STE 201
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City | MAYWOOD
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State | NJ
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Zip | 07607-1444
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Country | US
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Telephone | 888-554-9554
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 663
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City | FAIR LAWN
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State | NJ
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Zip | 07410-0663
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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 | 28RI03416100
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License Number State | NJ
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