Healthcare Provider Details

I. General information

NPI: 1053446344
Provider Name (Legal Business Name): FRANK MIELE PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4224 15TH AVE
BROOKLYN NY
11219-1512
US

IV. Provider business mailing address

4224 15TH AVE
BROOKLYN NY
11219-1512
US

V. Phone/Fax

Practice location:
  • Phone: 718-436-1964
  • Fax: 718-871-2877
Mailing address:
  • Phone: 718-436-1964
  • Fax: 718-871-2877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number009436
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: