Provider Demographics
NPI:1467634998
Name:BUCHALTER, JOSEPH ALLAN (R,PH,)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALLAN
Last Name:BUCHALTER
Suffix:
Gender:M
Credentials:R,PH,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:592 E 183RD ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-8701
Mailing Address - Country:US
Mailing Address - Phone:718-220-2226
Mailing Address - Fax:718-220-2533
Practice Address - Street 1:592 E 183RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-8701
Practice Address - Country:US
Practice Address - Phone:718-220-2226
Practice Address - Fax:718-220-2533
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist