Provider Demographics
NPI:1518245869
Name:CIERI, FREDERICK J (RPH)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:J
Last Name:CIERI
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 1:40 CEDAR STREET
Mailing Address - Street 2:
Mailing Address - City:NEWTINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111
Mailing Address - Country:US
Mailing Address - Phone:860-666-4079
Mailing Address - Fax:860-666-8818
Practice Address - Street 1:40 CEDAR STREET
Practice Address - Street 2:
Practice Address - City:NEWTINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111
Practice Address - Country:US
Practice Address - Phone:860-666-4079
Practice Address - Fax:860-666-8818
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4528183500000X
MT1384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist