Provider Demographics
NPI:1194016543
Name:AMATO, MICHAEL ANTHONY JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:AMATO
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:MICHAEL
Other - Middle Name:ANTHONY
Other - Last Name:AMATO
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:8 LOGAN PATH
Mailing Address - Street 2:
Mailing Address - City:NORTH GRAFTON
Mailing Address - State:MA
Mailing Address - Zip Code:01536-1010
Mailing Address - Country:US
Mailing Address - Phone:508-839-6424
Mailing Address - Fax:
Practice Address - Street 1:393 CHANDLER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602
Practice Address - Country:US
Practice Address - Phone:508-754-5348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist