Provider Demographics
NPI:1780999011
Name:MEROLA, ANTHONY V (RPH)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:V
Last Name:MEROLA
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 1:99 WASHINGTON AVE STE 720
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12210-2822
Mailing Address - Country:US
Mailing Address - Phone:518-486-3209
Mailing Address - Fax:518-473-5508
Practice Address - Street 1:99 WASHINGTON AVE STE 720
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12210-2822
Practice Address - Country:US
Practice Address - Phone:518-486-3209
Practice Address - Fax:518-473-5508
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist