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General NPI Number Information
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NPI Number | 1336317429
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Entity Type | Individual
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Provider Name | JOSEPH THOMAS DOHERTY RPH
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Gender | Male
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 999 CORPORATE DR T1139
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City | WESTBURY
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State | NY
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Zip | 11590-6614
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Country | US
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Telephone | 516-222-8841
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Fax | 516-222-8841
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Provider Business Mailing Address
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Address Line | 13 WOODLAND TER
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City | MERRICK
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State | NY
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Zip | 11566-3114
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Country | US
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Telephone | 516-867-0685
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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 | 029842
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License Number State | NY
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