Provider Demographics
NPI:1366764672
Name:LOBRUTTO, JOSEPH
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:LOBRUTTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WOODVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER TWP
Mailing Address - State:PA
Mailing Address - Zip Code:18706-5315
Mailing Address - Country:US
Mailing Address - Phone:570-466-1947
Mailing Address - Fax:
Practice Address - Street 1:1101 MOOSIC ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-2105
Practice Address - Country:US
Practice Address - Phone:570-347-6991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-28
Last Update Date:2010-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052808183500000X
PARP442804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist