Provider Demographics
NPI:1063615482
Name:MANGANELLI, JOSEPH V (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:V
Last Name:MANGANELLI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 ARLINGTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:NY
Mailing Address - Zip Code:10926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 CORPORATE BLVD S
Practice Address - Street 2:CMO
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-6806
Practice Address - Country:US
Practice Address - Phone:914-377-4716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035486-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist