Provider Demographics
NPI:1891734042
Name:DIBBINI, JOSEPH P (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:P
Last Name:DIBBINI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 BROOK ST
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5436
Mailing Address - Country:US
Mailing Address - Phone:914-725-1827
Mailing Address - Fax:914-725-6083
Practice Address - Street 1:199 BROOK ST
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5436
Practice Address - Country:US
Practice Address - Phone:914-725-1827
Practice Address - Fax:914-725-6083
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01018533Medicaid
NY0440750001Medicare ID - Type Unspecified