Provider Demographics
NPI:1700124005
Name:DELUCIA, JOSEPH E (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:E
Last Name:DELUCIA
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 1:73 E WHARF RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-3115
Mailing Address - Country:US
Mailing Address - Phone:203-421-6226
Mailing Address - Fax:
Practice Address - Street 1:73 E WHARF RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3115
Practice Address - Country:US
Practice Address - Phone:203-421-6226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist