Provider Demographics
NPI:1831377043
Name:MCGLYNN, JOSEPH JOHN JR (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JOHN
Last Name:MCGLYNN
Suffix:JR
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 1:1575 N 52ND ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-4736
Mailing Address - Country:US
Mailing Address - Phone:215-220-8800
Mailing Address - Fax:215-220-8888
Practice Address - Street 1:1575 N 52ND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-4736
Practice Address - Country:US
Practice Address - Phone:215-220-8800
Practice Address - Fax:215-220-8888
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01886400183500000X
PARP035549R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARPI004260OtherIMMUNIZATION CERTIFICATION
NJ28RJ03082OtherIMMUNIZATION CERTIFICATION