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NPI Code Detail

MEDICARE: JOSEPH P MANZULLO RPH

MEDICARE: JOSEPH P MANZULLO RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistA1-0004198DE
2183500000XPharmacist28RI02634900NJ
3183500000XPharmacistRP445628PA
4183500000XPharmacist056259-1NY

General Provider Information

NPI Number : 1629351697
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH P MANZULLO RPH
Provider Business Mailing Address
First Line : 112 WOODCREST AVE
Second Line :
City : ABSECON
State : NJ
Zip : 08201-1632
Country : US
Telephone Number : 609-742-5563
Fax Number :
Provider Business Practice Location Address
First Line : 402 N MAIN ST
Second Line :
City : ELMIRA
State : NY
Zip : 14901-2104
Country : US
Telephone Number : 609-742-5563
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2011
Last Update Date : 09/26/2011

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