Provider Demographics
NPI:1043442072
Name:WEBER, DENISE JOANNE (RPH)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:JOANNE
Last Name:WEBER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:WADING RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11792-2003
Mailing Address - Country:US
Mailing Address - Phone:631-929-6040
Mailing Address - Fax:631-929-0147
Practice Address - Street 1:6221 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:WADING RIVER
Practice Address - State:NY
Practice Address - Zip Code:11792-2003
Practice Address - Country:US
Practice Address - Phone:631-929-6040
Practice Address - Fax:631-929-0147
Is Sole Proprietor?:No
Enumeration Date:2009-08-09
Last Update Date:2009-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044996183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist