Provider Demographics
NPI:1023062841
Name:WARD, JOHN WOLLE (RPH, MS)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WOLLE
Last Name:WARD
Suffix:
Gender:M
Credentials:RPH, MS
Other - Prefix:
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Mailing Address - Street 1:485 1ST AVE
Mailing Address - Street 2:APT 5F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8605
Mailing Address - Country:US
Mailing Address - Phone:212-686-7500
Mailing Address - Fax:212-951-5451
Practice Address - Street 1:423 E 23RD ST
Practice Address - Street 2:PHARMACY/119
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5011
Practice Address - Country:US
Practice Address - Phone:212-686-7500
Practice Address - Fax:212-951-5451
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY30625183500000X
CA31276183500000X
NY030625-11835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist