Provider Demographics
NPI:1659695773
Name:JOSEPHER, LAWRENCE S (RPH)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:S
Last Name:JOSEPHER
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 1:3385 EDGERTON AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2938
Mailing Address - Country:US
Mailing Address - Phone:516-826-8329
Mailing Address - Fax:
Practice Address - Street 1:3385 EDGERTON AVE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-2938
Practice Address - Country:US
Practice Address - Phone:516-826-8329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033005183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist