Provider Demographics
NPI:1639493018
Name:CABAN, JOANN MARIE (RPH)
Entity Type:Individual
Prefix:MISS
First Name:JOANN
Middle Name:MARIE
Last Name:CABAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-2604
Mailing Address - Country:US
Mailing Address - Phone:845-265-6352
Mailing Address - Fax:845-265-6076
Practice Address - Street 1:55 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:NY
Practice Address - Zip Code:10516
Practice Address - Country:US
Practice Address - Phone:845-265-6352
Practice Address - Fax:845-265-6076
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048421-1183500000X
NY048421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist