Provider Demographics
NPI:1154916492
Name:JOSEPH, EMANUEL M (PHARMD)
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:M
Last Name:JOSEPH
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 1:2 WINTER ST APT D8
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-5094
Mailing Address - Country:US
Mailing Address - Phone:845-214-8094
Mailing Address - Fax:
Practice Address - Street 1:55 SPRINGFIELD PLAZA RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-2911
Practice Address - Country:US
Practice Address - Phone:802-885-5311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTX183500000X
VT033.0134508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist