Provider Demographics
NPI:1154510741
Name:LITTLE, JOAN E (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:E
Last Name:LITTLE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:JOAN
Other - Middle Name:E
Other - Last Name:MURAWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:265 POND PATH
Mailing Address - Street 2:
Mailing Address - City:SOUTH SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11720-2007
Mailing Address - Country:US
Mailing Address - Phone:631-580-5371
Mailing Address - Fax:631-580-5371
Practice Address - Street 1:265 POND PATH
Practice Address - Street 2:
Practice Address - City:SOUTH SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11720-2007
Practice Address - Country:US
Practice Address - Phone:631-580-5371
Practice Address - Fax:631-580-5371
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039527183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist