MEDICARE: MR. FRANK JEROME SABELLA RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	37851	NY

General Provider Information

NPI Number	:	1780908947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANK JEROME SABELLA RPH

Provider Business Mailing Address
First Line	:	2629 EIGHTH AVE
Second Line	:
City	:	EAST MEADOW
State	:	NY
Zip	:	11554
Country	:	US
Telephone Number	:	516-785-6963
Fax Number	:

Provider Business Practice Location Address
First Line	:	2758 GERRITSEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5915
Country	:	US
Telephone Number	:	718-332-7155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2010
Last Update Date	:	03/17/2010

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