Provider Demographics
NPI:1154601607
Name:YOSPA, ERIC JONATHAN (PD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JONATHAN
Last Name:YOSPA
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-2273
Mailing Address - Country:US
Mailing Address - Phone:410-239-3100
Mailing Address - Fax:410-239-6141
Practice Address - Street 1:907 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-2273
Practice Address - Country:US
Practice Address - Phone:410-239-3100
Practice Address - Fax:410-239-6141
Is Sole Proprietor?:No
Enumeration Date:2011-08-27
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist