Provider Demographics
NPI:1124150453
Name:BARTOSIK, JAMES ANTHONY SR (MBA, RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ANTHONY
Last Name:BARTOSIK
Suffix:SR
Gender:M
Credentials:MBA, RPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:1195 MAIN ST
Mailing Address - City:MALDEN ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12453-0011
Mailing Address - Country:US
Mailing Address - Phone:845-246-0715
Mailing Address - Fax:845-246-2245
Practice Address - Street 1:1195 MAIN ST
Practice Address - Street 2:
Practice Address - City:MALDEN ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12453-0011
Practice Address - Country:US
Practice Address - Phone:845-246-0715
Practice Address - Fax:845-246-2245
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist