Provider Demographics
NPI:1790007805
Name:NEMETH, JOHN CHARLES (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:NEMETH
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 1:3 WISNER TER
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-1524
Mailing Address - Country:US
Mailing Address - Phone:845-294-6239
Mailing Address - Fax:
Practice Address - Street 1:62 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-1929
Practice Address - Country:US
Practice Address - Phone:845-294-7474
Practice Address - Fax:845-294-2590
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033474-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist