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General NPI Number Information
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NPI Number | 1912220765
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Entity Type | Individual
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Provider Name | JOSEPH THOMAS COLOSA BS PHARMACY
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Gender | Male
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 629 E MAIN ST
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City | KINGS PARK
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State | NY
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Zip | 11754
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Country | US
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Telephone | 631-265-6404
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Fax | 631-265-6094
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Provider Business Mailing Address
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Address Line | 203 MELROSE PKWY
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-6268
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Country | US
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Telephone | 632-286-1382
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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 | 030121
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License Number State | NY
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