Provider Demographics
NPI:1225632862
Name:LEHAULT, WILLIAM (PHARMD, MS, BCPP)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:LEHAULT
Suffix:
Gender:M
Credentials:PHARMD, MS, BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 W LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-2605
Mailing Address - Country:US
Mailing Address - Phone:973-632-0728
Mailing Address - Fax:
Practice Address - Street 1:TWO MILE DRIVE
Practice Address - Street 2:
Practice Address - City:OTISVILLE
Practice Address - State:NY
Practice Address - Zip Code:10963
Practice Address - Country:US
Practice Address - Phone:845-386-6718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI033288001835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist