Provider Demographics
NPI:1679900583
Name:SANTISI, JOSEPH P (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:SANTISI
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 1:18 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1710
Mailing Address - Country:US
Mailing Address - Phone:732-545-6351
Mailing Address - Fax:
Practice Address - Street 1:1061 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-1424
Practice Address - Country:US
Practice Address - Phone:609-581-2583
Practice Address - Fax:609-585-5086
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02312300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist