Provider Demographics
NPI:1255653549
Name:RUNFOLA, FRANK ROBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:ROBERT
Last Name:RUNFOLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 POND RD
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-3410
Mailing Address - Country:US
Mailing Address - Phone:631-567-3324
Mailing Address - Fax:
Practice Address - Street 1:259 POND RD
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-3410
Practice Address - Country:US
Practice Address - Phone:631-567-3324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-27
Last Update Date:2010-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022733183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist