Individual
JONATHAN PETER DESTASIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
11 S WHITE HORSE PIKE, HAMMONTON, NJ 08037-1872
(609) 567-0177
(609) 704-1928
Mailing address
106 WEST LN, HAMMONTON, NJ 08037-1151
(609) 457-9082
(609) 567-3848
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03319200
NJ
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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