Provider Demographics
NPI:1861642779
Name:MAROTTA, JOSEPH M (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:M
Last Name:MAROTTA
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 1:31 HARDING RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-2209
Mailing Address - Country:US
Mailing Address - Phone:716-573-1871
Mailing Address - Fax:
Practice Address - Street 1:2032 CLINTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14206-3312
Practice Address - Country:US
Practice Address - Phone:716-824-5200
Practice Address - Fax:716-824-5201
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-27
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035801-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist