Provider Demographics
NPI:1073842381
Name:VONA, VINCENT JAMES (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:JAMES
Last Name:VONA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1768 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-4457
Mailing Address - Country:US
Mailing Address - Phone:631-655-0120
Mailing Address - Fax:631-655-0111
Practice Address - Street 1:1768 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-4457
Practice Address - Country:US
Practice Address - Phone:631-655-0120
Practice Address - Fax:631-655-0111
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI048839-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist