MEDICARE: ERIC D FROST PHARM D

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	I058271	NY

General Provider Information

NPI Number	:	1487023099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC D FROST PHARM D

Provider Business Mailing Address
First Line	:	1301 ULSTER AVE
Second Line	:
City	:	KINGSTON
State	:	NY
Zip	:	12401-1514
Country	:	US
Telephone Number	:	845-336-5955
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 ULSTER AVE
Second Line	:
City	:	KINGSTON
State	:	NY
Zip	:	12401-1514
Country	:	US
Telephone Number	:	845-336-5955
Fax Number	:

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

Provider Enumeration Date	:	09/24/2015
Last Update Date	:	09/24/2015

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