Provider Demographics
NPI:1407081847
Name:MACALUSO, JOSEPH DOMINICK (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DOMINICK
Last Name:MACALUSO
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 1:1441 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-1553
Mailing Address - Country:US
Mailing Address - Phone:718-698-2632
Mailing Address - Fax:
Practice Address - Street 1:1441 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1553
Practice Address - Country:US
Practice Address - Phone:718-698-2632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist