Healthcare Provider Details

I. General information

NPI: 1396052742
Provider Name (Legal Business Name): MINOS FRANGOS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2010
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

942 MANHATTAN AVE
BROOKLYN NY
11222-1626
US

IV. Provider business mailing address

942 MANHATTAN AVE
BROOKLYN NY
11222-1626
US

V. Phone/Fax

Practice location:
  • Phone: 718-500-4928
  • Fax:
Mailing address:
  • Phone: 718-500-4928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number054920
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: