Provider Demographics
NPI:1629073416
Name:DUBON, JOSEPH FRANCIS (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:DUBON
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 1:147 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5456
Mailing Address - Country:US
Mailing Address - Phone:516-822-2684
Mailing Address - Fax:
Practice Address - Street 1:147 5TH AVE
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-5456
Practice Address - Country:US
Practice Address - Phone:516-822-2684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030141183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist