Provider Demographics
NPI:1124242458
Name:MELLINA, FRANK J (RPH)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:J
Last Name:MELLINA
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 1:2527 CROPSEY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6603
Mailing Address - Country:US
Mailing Address - Phone:718-449-0434
Mailing Address - Fax:
Practice Address - Street 1:2527 CROPSEY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-6603
Practice Address - Country:US
Practice Address - Phone:718-449-0434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2011-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047708-1183500000X
NJ28RI02662000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist