Provider Demographics
NPI:1043437536
Name:FARIELLO, FRANK LEWIS (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:LEWIS
Last Name:FARIELLO
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 MONMOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-4534
Mailing Address - Country:US
Mailing Address - Phone:732-890-5804
Mailing Address - Fax:
Practice Address - Street 1:2175 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1009
Practice Address - Country:US
Practice Address - Phone:732-974-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02757100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist