Provider Demographics
NPI:1043822117
Name:FLERI, MITCHELL CONRAD (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:CONRAD
Last Name:FLERI
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BEECH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-5357
Mailing Address - Country:US
Mailing Address - Phone:207-216-3184
Mailing Address - Fax:
Practice Address - Street 1:72 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03862-2490
Practice Address - Country:US
Practice Address - Phone:603-964-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY-01037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist