MEDICARE: MR. FRANK WILLIAM DALESSANDRO III R PH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP033514L	PA

General Provider Information

NPI Number	:	1356491245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANK WILLIAM DALESSANDRO III R PH

Provider Business Mailing Address
First Line	:	1926 TEABERRY AVE
Second Line	:
City	:	WILLIAMSTOWN
State	:	NJ
Zip	:	08094-3355
Country	:	US
Telephone Number	:	856-863-1264
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 E CHELTENHAM AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19124-1103
Country	:	US
Telephone Number	:	215-535-4302
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	07/08/2007

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