Provider Demographics
NPI:1114070323
Name:MARCANTONIO, FRANCES M
Entity Type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:M
Last Name:MARCANTONIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PARK PL
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-7616
Mailing Address - Country:US
Mailing Address - Phone:203-237-1120
Mailing Address - Fax:203-235-0244
Practice Address - Street 1:172 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-4104
Practice Address - Country:US
Practice Address - Phone:203-235-6305
Practice Address - Fax:203-235-0244
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4461183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician