Provider Demographics
NPI:1922011188
Name:SPITALIERI, JOSEPH A (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:SPITALIERI
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 1:1 CHESEBROUGH ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3707
Mailing Address - Country:US
Mailing Address - Phone:718-227-7198
Mailing Address - Fax:
Practice Address - Street 1:15840 CROSSBAY BLVD
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-3136
Practice Address - Country:US
Practice Address - Phone:718-738-4343
Practice Address - Fax:718-845-1420
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035600-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist