Provider Demographics
NPI:1417011040
Name:FRANK, RALPH J JR (RPH, MPH)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:J
Last Name:FRANK
Suffix:JR
Gender:M
Credentials:RPH, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BUCKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-6702
Mailing Address - Country:US
Mailing Address - Phone:860-584-0683
Mailing Address - Fax:
Practice Address - Street 1:15 BUCKLEY AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-6702
Practice Address - Country:US
Practice Address - Phone:860-584-0683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist