Provider Demographics
NPI:1891732608
Name:DELOSSANTOS, JOSELITO GASPAR (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSELITO
Middle Name:GASPAR
Last Name:DELOSSANTOS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2200 PENFIELD ROAD
Mailing Address - Street 2:CVS PHARMACY #545
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526
Mailing Address - Country:US
Mailing Address - Phone:585-377-6170
Mailing Address - Fax:585-388-5667
Practice Address - Street 1:2200 PENFIELD ROAD
Practice Address - Street 2:CVS PHARMACY #545
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526
Practice Address - Country:US
Practice Address - Phone:585-377-6170
Practice Address - Fax:585-388-5667
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY046285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist