Provider Demographics
NPI:1013118165
Name:MELERO, SOEL SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:SOEL
Middle Name:
Last Name:MELERO
Suffix:SR
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 1:1024 COMMACK RD
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-8209
Mailing Address - Country:US
Mailing Address - Phone:631-586-3522
Mailing Address - Fax:
Practice Address - Street 1:1024 COMMACK RD
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-8209
Practice Address - Country:US
Practice Address - Phone:631-586-3522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030929183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist