Provider Demographics
NPI:1649595133
Name:OLES, MELISSA ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANNE
Last Name:OLES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3832
Mailing Address - Country:US
Mailing Address - Phone:845-338-8000
Mailing Address - Fax:845-338-5128
Practice Address - Street 1:86 N FRONT ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3832
Practice Address - Country:US
Practice Address - Phone:845-338-8000
Practice Address - Fax:845-338-5128
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist