Provider Demographics
NPI:1255624334
Name:ALBANO, ANTHONY JOHN (RPH)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JOHN
Last Name:ALBANO
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 1:133 WOODBROOK TER
Mailing Address - Street 2:
Mailing Address - City:W. SPRINFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089
Mailing Address - Country:US
Mailing Address - Phone:413-233-7430
Mailing Address - Fax:
Practice Address - Street 1:133 WOODBROOK TER
Practice Address - Street 2:
Practice Address - City:W SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4443
Practice Address - Country:US
Practice Address - Phone:413-233-7430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5345183500000X
MAPH16405183500000X
NH1991183500000X
VT033.0002830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist