Provider Demographics
NPI:1023548047
Name:SZURGYJLO, JOSEPH III
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SZURGYJLO
Suffix:III
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 1:1 TWIN CREEKS DR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:PA
Mailing Address - Zip Code:19373-1094
Mailing Address - Country:US
Mailing Address - Phone:610-731-7267
Mailing Address - Fax:
Practice Address - Street 1:1 TWIN CREEKS DR
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:PA
Practice Address - Zip Code:19373-1094
Practice Address - Country:US
Practice Address - Phone:610-731-7267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP442770OtherPHARMACY LICENSE
DEA1-0003824OtherDELAWARE LICENSE