Provider Demographics
NPI:1407480544
Name:PUSATERI, JOSPEH ROBERT (RPH)
Entity Type:Individual
Prefix:
First Name:JOSPEH
Middle Name:ROBERT
Last Name:PUSATERI
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 1:11 WOODRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-2039
Mailing Address - Country:US
Mailing Address - Phone:570-394-2146
Mailing Address - Fax:
Practice Address - Street 1:420 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:PA
Practice Address - Zip Code:18421-1420
Practice Address - Country:US
Practice Address - Phone:570-785-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036775L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist