Provider Demographics
NPI:1811170558
Name:VAGLIO, JOSEPH PATRICK (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:VAGLIO
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 1:4360 SUNRISE HWY
Mailing Address - Street 2:WALGREENS #9868
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5345
Mailing Address - Country:US
Mailing Address - Phone:516-799-1642
Mailing Address - Fax:
Practice Address - Street 1:4360 SUNRISE HWY
Practice Address - Street 2:WALGREENS #9868
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5345
Practice Address - Country:US
Practice Address - Phone:516-799-1642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist