Healthcare Provider Details

I. General information

NPI: 1487277588
Provider Name (Legal Business Name): FRANK ANTHONY LATTUCA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 05/22/2020
Certification Date: 05/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

87 TWIN OAK DR
ROCHESTER NY
14606-4413
US

V. Phone/Fax

Practice location:
  • Phone: 585-509-4824
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number064719
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: