Provider Demographics
NPI:1679734248
Name:LIZZUL, JOSEPH A (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:LIZZUL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 WESTCHESTER SQ
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:718-892-4222
Mailing Address - Fax:718-824-9013
Practice Address - Street 1:52 WESTCHESTER SQ
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-892-4222
Practice Address - Fax:718-824-9013
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist