Provider Demographics
NPI:1790070860
Name:PROSKY, JOANNE (RPH)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:PROSKY
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 1:15 COLONIAL CT
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NJ
Mailing Address - Zip Code:08833-4100
Mailing Address - Country:US
Mailing Address - Phone:908-236-9302
Mailing Address - Fax:
Practice Address - Street 1:15 COLONIAL CT
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NJ
Practice Address - Zip Code:08833-4100
Practice Address - Country:US
Practice Address - Phone:908-236-9302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R101713500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist