Provider Demographics
NPI:1467547810
Name:RILEY, FRANK M (RPH)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:M
Last Name:RILEY
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 1:42 TERRACE AVE.
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203
Mailing Address - Country:US
Mailing Address - Phone:518-463-2291
Mailing Address - Fax:518-463-1537
Practice Address - Street 1:100 BROADWAY
Practice Address - Street 2:
Practice Address - City:MENANDS
Practice Address - State:NY
Practice Address - Zip Code:12204
Practice Address - Country:US
Practice Address - Phone:518-463-2291
Practice Address - Fax:518-463-1537
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist