Provider Demographics
NPI:1194057182
Name:D'AGOSTINO, JOSEPH (BSPHARM, RPH)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:D'AGOSTINO
Suffix:
Gender:M
Credentials:BSPHARM, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PELHAM PKWY S
Mailing Address - Street 2:BN24
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1138
Mailing Address - Country:US
Mailing Address - Phone:718-918-4550
Mailing Address - Fax:718-918-7848
Practice Address - Street 1:1400 PELHAM PKWY S
Practice Address - Street 2:BN24
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-4550
Practice Address - Fax:718-918-7848
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist