Provider Demographics
NPI:1639359805
Name:NATALE, MICHAEL S (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:NATALE
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 1:2950 RIDGE RD W
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1643
Mailing Address - Country:US
Mailing Address - Phone:585-225-1210
Mailing Address - Fax:585-227-3006
Practice Address - Street 1:2950 RIDGE RD W
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-1643
Practice Address - Country:US
Practice Address - Phone:585-225-1210
Practice Address - Fax:585-227-3006
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00446864Medicaid