Provider Demographics
NPI:1306028592
Name:YOZZO, DONALD A II (PHARMACIST)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:A
Last Name:YOZZO
Suffix:II
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 4TH AVE
Mailing Address - Street 2:307 FOURTH AVE
Mailing Address - City:FRANKFORT
Mailing Address - State:NY
Mailing Address - Zip Code:13340-1407
Mailing Address - Country:US
Mailing Address - Phone:315-894-8302
Mailing Address - Fax:
Practice Address - Street 1:323 E ALBANY ST
Practice Address - Street 2:323 EAST ALBANY ST
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-2016
Practice Address - Country:US
Practice Address - Phone:315-866-0274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00572665Medicaid