Provider Demographics
NPI:1396011177
Name:YOCKELSON, NORMAN RALPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:RALPH
Last Name:YOCKELSON
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:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20830-0045
Mailing Address - Country:US
Mailing Address - Phone:301-961-1099
Mailing Address - Fax:
Practice Address - Street 1:10 MONOCACY BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-7256
Practice Address - Country:US
Practice Address - Phone:301-644-1482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist