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General NPI Number Information
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NPI Number | 1356750491
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY IAFRATE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2014
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Last Update Date | 08/02/2014
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Provider Practice Location Address
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Address Line | 1510 SMITH ST
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02911-2918
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Country | US
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Telephone | 401-353-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 79 STILLWATER AVE
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02908-1126
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Country | US
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Telephone | 401-644-5292
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH05350
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License Number State | RI
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