Provider Demographics
NPI:1417279555
Name:GUILLOT, FRANK T (RPH)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:T
Last Name:GUILLOT
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 1:405 WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-5115
Mailing Address - Country:US
Mailing Address - Phone:631-676-6181
Mailing Address - Fax:631-676-6181
Practice Address - Street 1:1660 WALT WHITMAN RD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4107
Practice Address - Country:US
Practice Address - Phone:631-547-6520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045603183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY045603OtherNY STATE LICENSE NUMBER