Provider Demographics
NPI:1558352807
Name:BOSKELLO, FRANK MICHAEL SR (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:MICHAEL
Last Name:BOSKELLO
Suffix:SR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-4022
Mailing Address - Country:US
Mailing Address - Phone:203-334-5163
Mailing Address - Fax:203-331-0431
Practice Address - Street 1:1125 HIGH ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-4022
Practice Address - Country:US
Practice Address - Phone:203-334-5163
Practice Address - Fax:203-331-0431
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist