Provider Demographics
NPI:1053446344
Name:MIELE, FRANK (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:MIELE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-1512
Mailing Address - Country:US
Mailing Address - Phone:718-436-1964
Mailing Address - Fax:718-871-2877
Practice Address - Street 1:4224 15TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-1512
Practice Address - Country:US
Practice Address - Phone:718-436-1964
Practice Address - Fax:718-871-2877
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00262299Medicaid
NY009436OtherSTATE LICENSE INFORMATION