Provider Demographics
NPI:1972191500
Name:YOKOSE, RYOTA ALEX (PHARMD)
Entity Type:Individual
Prefix:
First Name:RYOTA
Middle Name:ALEX
Last Name:YOKOSE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 AUTUMN POND WAY UNIT 306
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-4078
Mailing Address - Country:US
Mailing Address - Phone:802-777-9097
Mailing Address - Fax:
Practice Address - Street 1:323 AUTUMN POND WAY UNIT 306
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-4078
Practice Address - Country:US
Practice Address - Phone:802-777-9097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0134462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist