Healthcare Provider Details

I. General information

NPI: 1104004456
Provider Name (Legal Business Name): ALAN CARL FRUSTIERI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 03/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 9TH AVE APT. 9TH FLOOR
NEW YORK NY
10001-1620
US

IV. Provider business mailing address

300 W 23RD ST APT. 3J
NEW YORK NY
10011-2210
US

V. Phone/Fax

Practice location:
  • Phone: 212-273-5700
  • Fax:
Mailing address:
  • Phone: 212-255-7339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number042483
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: