Daniel J Deodati, RPH
Individual provider Active NPI Pharmacist · Wind Gap, PA
NPI 1962725614 · NPPES record last updated Mar 9, 2010
Key facts
- NPI
- 1962725614
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP036470R (PA)
- Practice address
- 803 Male Rd
Wind Gap, PA 18091-1500 - Phone
- (610) 863-7535
- Fax
- (610) 863-1016
- NPI assigned
- Mar 9, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28R101800800 | NJ | MD | Pharmacist |
| RP036470R | PA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP036470R | PA | Yes |
| Pharmacist | 183500000X | 28R101800800 | NJ |
Addresses
Primary practice location
803 Male Rd
Wind Gap, PA 18091-1500
Mailing address
803 Male Rd
Wind Gap, PA 18091-1500
Phone (610) 863-7535
Other providers in Wind Gap, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.