Provider Demographics
NPI:1588939656
Name:DEPALO, JOSEPH P (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:P
Last Name:DEPALO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 NH ROUTE 120
Mailing Address - Street 2:
Mailing Address - City:CORNISH
Mailing Address - State:NH
Mailing Address - Zip Code:03745-4651
Mailing Address - Country:US
Mailing Address - Phone:603-477-3081
Mailing Address - Fax:
Practice Address - Street 1:653 NH ROUTE 120
Practice Address - Street 2:
Practice Address - City:CORNISH
Practice Address - State:NH
Practice Address - Zip Code:03745-4651
Practice Address - Country:US
Practice Address - Phone:603-477-3081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist