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General NPI Number Information
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NPI Number | 1982649745
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Entity Type | Organization
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Legal Business Name | MIKE-PAUL CORP
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2673 W MAIN ST
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City | WAPPINGERS FALLS
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State | NY
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Zip | 12590-1941
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Country | US
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Telephone | 845-297-3731
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Fax | 845-297-4126
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Provider Business Mailing Address
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Address Line | 2673 W MAIN ST
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City | WAPPINGERS FALLS
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State | NY
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Zip | 12590-1941
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Country | US
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Telephone | 845-297-3731
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Fax | 845-297-4126
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JOHN P. FRATTO
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Credential | RPH
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Telephone | 845-297-3731
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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 | 022574
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License Number State | NY
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