Provider Demographics
NPI:1689190753
Name:DIAFERIO, FRANK NICHOLAS III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:NICHOLAS
Last Name:DIAFERIO
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:792 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-4117
Mailing Address - Country:US
Mailing Address - Phone:203-754-0181
Mailing Address - Fax:
Practice Address - Street 1:792 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-4117
Practice Address - Country:US
Practice Address - Phone:203-754-0181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0014220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist