Provider Demographics
NPI:1821201229
Name:LLOYD, JONATHAN (RPH)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:LLOYD
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 1:2734 STATE ROUTE 7
Mailing Address - Street 2:
Mailing Address - City:VALLEY FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12185-2516
Mailing Address - Country:US
Mailing Address - Phone:518-663-8301
Mailing Address - Fax:
Practice Address - Street 1:210 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-1755
Practice Address - Country:US
Practice Address - Phone:802-442-6822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT2916183500000X
NY35479-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist