Provider Demographics
NPI:1003139544
Name:FOX, MICHAEL ARNOLD (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ARNOLD
Last Name:FOX
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3948 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-5111
Mailing Address - Country:US
Mailing Address - Phone:718-356-1789
Mailing Address - Fax:718-356-1777
Practice Address - Street 1:3948 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-5111
Practice Address - Country:US
Practice Address - Phone:718-356-1789
Practice Address - Fax:718-356-1777
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028145183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist