Provider Demographics
NPI:1396905741
Name:SCALESE, JOSEPH J III
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:J
Last Name:SCALESE
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 CHASE SIX BLVD
Mailing Address - Street 2:
Mailing Address - City:BOONSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21713-2059
Mailing Address - Country:US
Mailing Address - Phone:301-432-3953
Mailing Address - Fax:301-432-3955
Practice Address - Street 1:700 CHASE SIX BLVD
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-2059
Practice Address - Country:US
Practice Address - Phone:301-432-3953
Practice Address - Fax:301-432-3955
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13622183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist