Provider Demographics
NPI:1952624173
Name:VIGILANTE, FRANK ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:ANTHONY
Last Name:VIGILANTE
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 1:141 SAWKILL RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-7101
Mailing Address - Country:US
Mailing Address - Phone:917-664-4074
Mailing Address - Fax:
Practice Address - Street 1:80 RED SCHOOLHOUSE RD
Practice Address - Street 2:SUITE 226
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-7053
Practice Address - Country:US
Practice Address - Phone:800-221-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041515-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY041515OtherNY STATE PHARMACY LICENSE #