Provider Demographics
NPI:1558686808
Name:MEGLIO, RANDAL S (RPH)
Entity Type:Individual
Prefix:MR
First Name:RANDAL
Middle Name:S
Last Name:MEGLIO
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 1:506 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07504-1532
Mailing Address - Country:US
Mailing Address - Phone:973-279-4600
Mailing Address - Fax:
Practice Address - Street 1:506 PARK AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07504-1532
Practice Address - Country:US
Practice Address - Phone:973-342-3905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI18764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist