Provider Demographics
NPI:1043542319
Name:JOSEPH-JULES, CARMELITE MARIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:CARMELITE
Middle Name:MARIE
Last Name:JOSEPH-JULES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:CARMELITE
Other - Middle Name:MARIE
Other - Last Name:JOSEPH-JULES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:11602 BEACH CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11694-2073
Mailing Address - Country:US
Mailing Address - Phone:718-945-7781
Mailing Address - Fax:718-945-7785
Practice Address - Street 1:11602 BEACH CHANNEL DR
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-2073
Practice Address - Country:US
Practice Address - Phone:718-945-7781
Practice Address - Fax:718-945-7785
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0505601183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY64119Medicaid